wikidoc - User contributions [en]

Cerebellar cystic astrocytoma

2015-10-21T19:26:18Z

Ahmad Al Maradni: ←Redirected page to Pilocytic astrocytoma

#redirect[[Pilocytic astrocytoma]]

Cystic cerebellar astrocytoma

2015-10-21T19:24:42Z

Ahmad Al Maradni: ←Redirected page to Pilocytic astrocytoma

#redirect[[Pilocytic astrocytoma]]

Pilocytic astrocytoma

2015-10-21T19:23:33Z

Ahmad Al Maradni:

__NOTOC__
{{Pilocytic astrocytoma}}
{{CMG}} {{AE}} {{AAM}}

{{SK}} Juvenile pilocytic astrocytoma; JPA; Pilocytic astrocytomas; Cystic cerebellar astrocytoma
==[[Pilocytic astrocytoma overview|Overview]]==

==[[Pilocytic astrocytoma historical perspective|Historical Perspective]]==

==[[Pilocytic astrocytoma classification|Classification]]==

==[[Pilocytic astrocytoma pathophysiology|Pathophysiology]]==

==[[Pilocytic astrocytoma causes|Causes]]==

==[[Pilocytic astrocytoma epidemiology and demographics|Epidemiology and Demographics]]==

==[[Pilocytic astrocytoma epidemiology and demographics|Risk Factors]]==

==[[Pilocytic astrocytoma differential diagnosis|Differentiating Ependymoma from other Diseases]]==

==[[Pilocytic astrocytoma natural history|Natural History, Complications and Prognosis]]==

==Diagnosis==
[[Pilocytic astrocytoma history and symptoms|History and Symptoms]] | [[Pilocytic astrocytoma physical examination|Physical Examination]] | [[Pilocytic astrocytoma staging|Staging]] | [[Pilocytic astrocytoma laboratory tests|Laboratory Findings]] | [[Pilocytic astrocytoma CT|CT]] | [[Pilocytic astrocytoma MRI|MRI]] | [[Pilocytic astrocytoma ultrasound|Ultrasound]] | [[Pilocytic astrocytoma other imaging findings|Other Imaging Findings]] | [[Pilocytic astrocytoma other diagnostic studies|Other Diagnostic Studies]]

==Treatment==
[[Pilocytic astrocytoma medical therapy|Medical Therapy]] | [[Pilocytic astrocytoma surgery|Surgery]] | [[Pilocytic astrocytoma primary prevention|Primary Prevention]] | [[Pilocytic astrocytoma secondary prevention|Secondary Prevention]] | [[Pilocytic astrocytoma cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Pilocytic astrocytoma future or investigational therapies|Future or Investigational Therapies]]

==References==
{{Tumors}}
{{Nervous tissue tumors}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Oncology]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Pilocytic astrocytomas

2015-10-21T19:13:19Z

Ahmad Al Maradni: ←Redirected page to Pilocytic astrocytoma

#redirect[[ Pilocytic astrocytoma]]

Pilocytic astrocytoma

2015-10-21T19:12:19Z

Ahmad Al Maradni:

__NOTOC__
{{Pilocytic astrocytoma}}
{{CMG}} {{AE}} {{AAM}}

{{SK}} Juvenile pilocytic astrocytoma; JPA; Pilocytic astrocytomas
==[[Pilocytic astrocytoma overview|Overview]]==

==[[Pilocytic astrocytoma historical perspective|Historical Perspective]]==

==[[Pilocytic astrocytoma classification|Classification]]==

==[[Pilocytic astrocytoma pathophysiology|Pathophysiology]]==

==[[Pilocytic astrocytoma causes|Causes]]==

==[[Pilocytic astrocytoma epidemiology and demographics|Epidemiology and Demographics]]==

==[[Pilocytic astrocytoma epidemiology and demographics|Risk Factors]]==

==[[Pilocytic astrocytoma differential diagnosis|Differentiating Ependymoma from other Diseases]]==

==[[Pilocytic astrocytoma natural history|Natural History, Complications and Prognosis]]==

==Diagnosis==
[[Pilocytic astrocytoma history and symptoms|History and Symptoms]] | [[Pilocytic astrocytoma physical examination|Physical Examination]] | [[Pilocytic astrocytoma staging|Staging]] | [[Pilocytic astrocytoma laboratory tests|Laboratory Findings]] | [[Pilocytic astrocytoma CT|CT]] | [[Pilocytic astrocytoma MRI|MRI]] | [[Pilocytic astrocytoma ultrasound|Ultrasound]] | [[Pilocytic astrocytoma other imaging findings|Other Imaging Findings]] | [[Pilocytic astrocytoma other diagnostic studies|Other Diagnostic Studies]]

==Treatment==
[[Pilocytic astrocytoma medical therapy|Medical Therapy]] | [[Pilocytic astrocytoma surgery|Surgery]] | [[Pilocytic astrocytoma primary prevention|Primary Prevention]] | [[Pilocytic astrocytoma secondary prevention|Secondary Prevention]] | [[Pilocytic astrocytoma cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Pilocytic astrocytoma future or investigational therapies|Future or Investigational Therapies]]

==References==
{{Tumors}}
{{Nervous tissue tumors}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Oncology]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Pilocytic astrocytoma (patient information)

2015-10-21T19:09:55Z

Ahmad Al Maradni: Created page with "{{Pleasehelp}}"

Pilocytic astrocytoma

2015-10-21T19:08:55Z

Ahmad Al Maradni:

__NOTOC__
{{Pilocytic astrocytoma}}
{{CMG}} {{AE}} {{AAM}}

{{SK}}
==[[Pilocytic astrocytoma overview|Overview]]==

==[[Pilocytic astrocytoma historical perspective|Historical Perspective]]==

==[[Pilocytic astrocytoma classification|Classification]]==

==[[Pilocytic astrocytoma pathophysiology|Pathophysiology]]==

==[[Pilocytic astrocytoma causes|Causes]]==

==[[Pilocytic astrocytoma epidemiology and demographics|Epidemiology and Demographics]]==

==[[Pilocytic astrocytoma epidemiology and demographics|Risk Factors]]==

==[[Pilocytic astrocytoma differential diagnosis|Differentiating Ependymoma from other Diseases]]==

==[[Pilocytic astrocytoma natural history|Natural History, Complications and Prognosis]]==

==Diagnosis==
[[Pilocytic astrocytoma history and symptoms|History and Symptoms]] | [[Pilocytic astrocytoma physical examination|Physical Examination]] | [[Pilocytic astrocytoma staging|Staging]] | [[Pilocytic astrocytoma laboratory tests|Laboratory Findings]] | [[Pilocytic astrocytoma CT|CT]] | [[Pilocytic astrocytoma MRI|MRI]] | [[Pilocytic astrocytoma ultrasound|Ultrasound]] | [[Pilocytic astrocytoma other imaging findings|Other Imaging Findings]] | [[Pilocytic astrocytoma other diagnostic studies|Other Diagnostic Studies]]

==Treatment==
[[Pilocytic astrocytoma medical therapy|Medical Therapy]] | [[Pilocytic astrocytoma surgery|Surgery]] | [[Pilocytic astrocytoma primary prevention|Primary Prevention]] | [[Pilocytic astrocytoma secondary prevention|Secondary Prevention]] | [[Pilocytic astrocytoma cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Pilocytic astrocytoma future or investigational therapies|Future or Investigational Therapies]]

==References==
{{Tumors}}
{{Nervous tissue tumors}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Oncology]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

JPA

2015-10-21T19:08:01Z

Ahmad Al Maradni: ←Redirected page to Pilocytic astrocytoma

#redirect[[Pilocytic astrocytoma]]

Bone or cartilage mass causes

2015-10-21T15:42:22Z

Ahmad Al Maradni: Created page with "{|style="width:80%; height:100px" border="1" |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular''' |style="height:100px"; style="w..."

{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|-
|}

*[[Osteomyelitis]]
*[[Giant cell tumor of bone|Giant cell tumors]]
*[[Ewing's sarcoma]]
*[[Malignant fibrous histiocytoma]]
*[[Lymphoma]]
*[[Osteoblastoma]]
*[[Aneurysmal bone cyst]]
*[[Rhabdomyosarcoma]]
*[[Fibrosarcoma]]
*Cortical desmoid

File:G04nv32g02c.jpeg.gif

2015-10-21T14:14:54Z

Ahmad Al Maradni:

File:G04nv32g02b.jpeg.gif

2015-10-21T14:10:32Z

Ahmad Al Maradni:

File:Pilo CT cytic1234.gif

2015-10-21T13:50:01Z

Ahmad Al Maradni:

File:G04nv32c10e.jpeg.gif

2015-10-20T20:13:09Z

Ahmad Al Maradni:

File:G04nv32c04e.jpeg.gif

2015-10-20T20:11:27Z

Ahmad Al Maradni:

Pilocytic astrocytoma

2015-10-20T19:45:16Z

Ahmad Al Maradni:

__NOTOC__
'''For patient information, click [[Ependymoma (patient information)|here]]'''

{{SI}}
{{CMG}} {{AE}} {{AAM}}

{{SK}}
==[[Pilocytic Astorcytoma overview|Overview]]==

==[[Pilocytic Astorcytoma historical perspective|Historical Perspective]]==

==[[Pilocytic Astorcytoma classification|Classification]]==

==[[Pilocytic Astorcytoma pathophysiology|Pathophysiology]]==

==[[Pilocytic Astorcytoma causes|Causes]]==

==[[Pilocytic Astorcytoma epidemiology and demographics|Epidemiology and Demographics]]==

==[[Pilocytic Astorcytoma epidemiology and demographics|Risk Factors]]==

==[[Pilocytic Astorcytoma differential diagnosis|Differentiating Ependymoma from other Diseases]]==

==[[Pilocytic Astorcytoma natural history|Natural History, Complications and Prognosis]]==

==Diagnosis==
[[Pilocytic Astorcytoma history and symptoms|History and Symptoms]] | [[Pilocytic Astorcytoma physical examination|Physical Examination]] | [[Pilocytic Astorcytoma staging|Staging]] | [[Pilocytic Astorcytoma laboratory tests|Laboratory Findings]] | [[Pilocytic Astorcytoma CT|CT]] | [[Pilocytic Astorcytoma MRI|MRI]] | [[Pilocytic Astorcytoma ultrasound|Ultrasound]] | [[Pilocytic Astorcytoma other imaging findings|Other Imaging Findings]] | [[Pilocytic Astorcytoma other diagnostic studies|Other Diagnostic Studies]]

==Treatment==
[[Pilocytic Astorcytoma medical therapy|Medical Therapy]] | [[Pilocytic Astorcytoma surgery|Surgery]] | [[Pilocytic Astorcytoma primary prevention|Primary Prevention]] | [[Pilocytic Astorcytoma secondary prevention|Secondary Prevention]] | [[Pilocytic Astorcytoma cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Pilocytic Astorcytoma future or investigational therapies|Future or Investigational Therapies]]

==References==
{{Tumors}}
{{Nervous tissue tumors}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Oncology]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Pilocytic astrocytoma

2015-10-20T19:00:01Z

Ahmad Al Maradni: Replaced content with "{{SI}} {{CMG}}"

File:Pilo123456.jpg

2015-10-20T15:48:30Z

Ahmad Al Maradni: Ahmad Al Maradni uploaded a new version of File:Pilo123456.jpg

File:Pilo123456.jpg

2015-10-20T15:48:11Z

Ahmad Al Maradni:

File:12342222 piloo.jpg

2015-10-20T15:45:25Z

Ahmad Al Maradni: Ahmad Al Maradni uploaded a new version of File:12342222 piloo.jpg

File:12342222 piloo.jpg

2015-10-20T15:45:03Z

Ahmad Al Maradni:

File:753-11649-1-PBpilo21234.jpg

2015-10-20T15:27:31Z

Ahmad Al Maradni: Ahmad Al Maradni uploaded a new version of File:753-11649-1-PBpilo21234.jpg

File:753-11649-1-PBpilo21234.jpg

2015-10-20T15:27:10Z

Ahmad Al Maradni:

File:753-11648-1-PB pilo11.jpg

2015-10-20T15:24:37Z

Ahmad Al Maradni: Ahmad Al Maradni uploaded a new version of File:753-11648-1-PB pilo11.jpg

File:753-11648-1-PB pilo11.jpg

2015-10-20T15:24:09Z

Ahmad Al Maradni:

Ependymoma MRI

2015-10-16T13:47:33Z

Ahmad Al Maradni: /* MRI */

__NOTOC__
{{Ependymoma}}
{{CMG}} {{AE}} {{AAM}}

==Overview==
Brain MRI may be diagnostic of ependymoma. Finding on brain MRI suggestive of ependymoma include large mixed cystic/solid lesion with [[haemorrhage]] and [[fluid]] which may indicate areas of [[necrosis]].

==MRI==
*T1
:*Solid portions of ependymoma typically are isointense to hypointense relative to white matter

*T2
:*Hyperintense to white matter
:*More reliable in differentiating tumor margins than non-contrast T1-weighted images (but less reliable than contrast enhanced T1)

*T2* (e.g. SWI)
:*Foci of blooming from [[haemorrhage]] or [[calcification]]

*T1 C+ (Gd)
:*Enhancement present but [[heterogeneous]]
:*Enhancement with [[gadolinium]] is useful in differentiating tumor from adjacent [[vasogenic edema]] and normal brain parenchyma.
*DWI (diffusion weighted MRI)
:*Restricted [[diffusion]] may be seen in solid components especially in [[anaplastic|anaplastic tumour]]
:*Diffusion should be interpreted with caution in masses with significant haemorrhage or calcification
*MR Spectroscopy
:*[[Choline]] peak elevation according to the cellularity of tumor
:*[[N-Acetylaspartate]] peak reduction
:*Elevated [[choline]]/[[creatinine]] ratio
:*[[Lipid]] and [[lactate]] rise when degeneration occurs
<gallery>
Image:
A91344c612b07b087964a93ee047df big gallery.jpg|T1<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
73c54460c3e8d80f3d18cd522ed152 big gallery.jpg|T2<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
Ependymoma-lateral-ventricle(5).jpg|FLAIR<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
Ependymoma-lateral-ventricle(7).jpg|T1<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
Ependymoma-lateral-ventricle(97777).jpg|T1 C+<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
Ependymoma-lateral-ventricle(9).jpg|DWI<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
</gallery>
''Note'':There is a large left frontal mixed cystic/solid lesion, measuring approximately 4x4x5cm in perpendicular dimensions, with intralesional haemorrhage and fluid level which may indicate areas of necrosis. Large surrounding vasogenic edema involving the contralateral hemisphere, and significant mass effect causing almost 2cm midline shift, obstructing the monro foramina resulting moderate non-communicating hydrocephalus.

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma MRI

2015-10-16T13:36:32Z

Ahmad Al Maradni: /* MRI */

__NOTOC__
{{Ependymoma}}
{{CMG}} {{AE}} {{AAM}}

==Overview==
Brain MRI may be diagnostic of ependymoma. Finding on brain MRI suggestive of ependymoma include large mixed cystic/solid lesion with [[haemorrhage]] and [[fluid]] which may indicate areas of [[necrosis]].

==MRI==
*T1
:*Solid portions of ependymoma typically are isointense to hypointense relative to white matter

*T2
:*Hyperintense to white matter
:*More reliable in differentiating tumor margins than non-contrast T1-weighted images (but less reliable than contrast enhanced T1)

*T2* (e.g. SWI)
:*Foci of blooming from [[haemorrhage]] or [[calcification]]

*T1 C+ (Gd)
:*Enhancement present but [[heterogeneous]]
:*Enhancement with [[gadolinium]] is useful in differentiating tumor from adjacent [[vasogenic edema]] and normal brain parenchyma.
*DWI/ADC
:*Restricted [[diffusion]] may be seen in solid components especially in [[anaplastic|anaplastic tumour]]
:*Diffusion should be interpreted with caution in masses with significant haemorrhage or calcification
*MR Spectroscopy
:*[[Choline]] peak elevation according to the cellularity of tumor
:*[[N-Acetylaspartate]] peak reduction
:*Elevated [[choline]]/[[creatinine]] ratio
:*[[Lipid]] and [[lactate]] rise when degeneration occurs
<gallery>
Image:
A91344c612b07b087964a93ee047df big gallery.jpg|T1<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
73c54460c3e8d80f3d18cd522ed152 big gallery.jpg|T2<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
Ependymoma-lateral-ventricle(5).jpg|FLAIR<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
Ependymoma-lateral-ventricle(7).jpg|T1<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
Ependymoma-lateral-ventricle(97777).jpg|T1 C+<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
Ependymoma-lateral-ventricle(9).jpg|DWI<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
</gallery>
''Note'':There is a large left frontal mixed cystic/solid lesion, measuring approximately 4x4x5cm in perpendicular dimensions, with intralesional haemorrhage and fluid level which may indicate areas of necrosis. Large surrounding vasogenic edema involving the contralateral hemisphere, and significant mass effect causing almost 2cm midline shift, obstructing the monro foramina resulting moderate non-communicating hydrocephalus.

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma MRI

2015-10-16T13:35:00Z

Ahmad Al Maradni: /* MRI */

__NOTOC__
{{Ependymoma}}
{{CMG}} {{AE}} {{AAM}}

==Overview==
Brain MRI may be diagnostic of ependymoma. Finding on brain MRI suggestive of ependymoma include large mixed cystic/solid lesion with [[haemorrhage]] and [[fluid]] which may indicate areas of [[necrosis]].

==MRI==
*T1
:*Solid portions of ependymoma typically are isointense to hypointense relative to white matter

*T2
:*Hyperintense to white matter
:*More reliable in differentiating tumor margins than non-contrast T1-weighted images (but less reliable than contrast enhanced T1)

*T2* (e.g. SWI)
:*Foci of blooming from [[haemorrhage]] or [[calcification]]

*T1 C+ (Gd)
:*Enhancement present but [[heterogeneous]]
:*Enhancement with [[gadolinium]] is useful in differentiating tumor from adjacent [[vasogenic edema]] and normal brain parenchyma.

*MR Spectroscopy
:*[[Choline]] peak elevation according to the cellularity of tumor
:*[[N-Acetylaspartate]] peak reduction
:*Elevated [[choline]]/[[creatinine]] ratio
:*[[Lipid]] and [[lactate]] rise when degeneration occurs
<gallery>
Image:
A91344c612b07b087964a93ee047df big gallery.jpg|T1<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
73c54460c3e8d80f3d18cd522ed152 big gallery.jpg|T2<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
Ependymoma-lateral-ventricle(5).jpg|FLAIR<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
Ependymoma-lateral-ventricle(7).jpg|T1<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
Ependymoma-lateral-ventricle(97777).jpg|T1 C+<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
Ependymoma-lateral-ventricle(9).jpg|DWI<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
</gallery>
''Note'':There is a large left frontal mixed cystic/solid lesion, measuring approximately 4x4x5cm in perpendicular dimensions, with intralesional haemorrhage and fluid level which may indicate areas of necrosis. Large surrounding vasogenic edema involving the contralateral hemisphere, and significant mass effect causing almost 2cm midline shift, obstructing the monro foramina resulting moderate non-communicating hydrocephalus.

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma MRI

2015-10-16T13:34:20Z

Ahmad Al Maradni: /* MRI */

__NOTOC__
{{Ependymoma}}
{{CMG}} {{AE}} {{AAM}}

==Overview==
Brain MRI may be diagnostic of ependymoma. Finding on brain MRI suggestive of ependymoma include large mixed cystic/solid lesion with [[haemorrhage]] and [[fluid]] which may indicate areas of [[necrosis]].

==MRI==
*T1
:*Solid portions of ependymoma typically are isointense to hypointense relative to white matter

*T2
:*Hyperintense to white matter
:*More reliable in differentiating tumor margins than non-contrast T1-weighted images (but less reliable than contrast enhanced T1)

*T2* (e.g. SWI)
:*Foci of blooming from [[haemorrhage]] or [[calcification]]

*T1 C+ (Gd)
:*Enhancement present but [[heterogeneous]]
:*Enhancement with [[gadolinium]] is useful in differentiating tumor from adjacent [[vasogenic edema]] and normal brain parenchyma

*DWI/ADC
:*Restricted [[diffusion]] may be seen in solid components especially in [[anaplastic|anaplastic tumour]]
:*Diffusion should be interpreted with caution in masses with significant haemorrhage or calcification

*MR Spectroscopy
:*[[Choline]] peak elevation according to the cellularity of tumor
:*[[N-Acetylaspartate]] peak reduction
:*Elevated [[choline]]/[[creatinine]] ratio
:*[[Lipid]] and [[lactate]] rise when degeneration occurs
<gallery>
Image:
A91344c612b07b087964a93ee047df big gallery.jpg|T1<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
73c54460c3e8d80f3d18cd522ed152 big gallery.jpg|T2<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
Ependymoma-lateral-ventricle(5).jpg|FLAIR<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
Ependymoma-lateral-ventricle(7).jpg|T1<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
Ependymoma-lateral-ventricle(97777).jpg|T1 C+<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
Ependymoma-lateral-ventricle(9).jpg|DWI<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
</gallery>
''Note'':There is a large left frontal mixed cystic/solid lesion, measuring approximately 4x4x5cm in perpendicular dimensions, with intralesional haemorrhage and fluid level which may indicate areas of necrosis. Large surrounding vasogenic edema involving the contralateral hemisphere, and significant mass effect causing almost 2cm midline shift, obstructing the monro foramina resulting moderate non-communicating hydrocephalus.

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma MRI

2015-10-16T13:31:16Z

Ahmad Al Maradni: /* MRI */

__NOTOC__
{{Ependymoma}}
{{CMG}} {{AE}} {{AAM}}

==Overview==
Brain MRI may be diagnostic of ependymoma. Finding on brain MRI suggestive of ependymoma include large mixed cystic/solid lesion with [[haemorrhage]] and [[fluid]] which may indicate areas of [[necrosis]].

==MRI==
*T1
:*Solid portions of ependymoma typically are isointense to hypointense relative to white matter

*T2
:*Hyperintense to white matter
:*More reliable in differentiating tumor margins than non-contrast T1-weighted images (but less reliable than contrast enhanced T1)

*T2* (e.g. SWI)
:*Foci of blooming from [[haemorrhage]] or [[calcification]]

*T1 C+ (Gd)
:*Enhancement present but [[heterogeneous]]
:*Enhancement with [[gadolinium]] is useful in differentiating tumor from adjacent [[vasogenic edema]] and normal brain parenchyma

*DWI/ADC
:*Restricted [[diffusion]] may be seen in solid components especially in [[anaplastic|anaplastic tumour]]
:*Diffusion should be interpreted with caution in masses with significant haemorrhage or calcification

*MRS
:*[[Choline]] peak elevation according to the cellularity of tumor
:*[[N-Acetylaspartate]] peak reduction
:*Elevated [[choline]]/[[creatinine]] ratio
:*[[Lipid]] and [[lactate]] rise when degeneration occurs
<gallery>
Image:
A91344c612b07b087964a93ee047df big gallery.jpg|T1<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
73c54460c3e8d80f3d18cd522ed152 big gallery.jpg|T2<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
Ependymoma-lateral-ventricle(5).jpg|FLAIR<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
Ependymoma-lateral-ventricle(7).jpg|T1<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
Ependymoma-lateral-ventricle(97777).jpg|T1 C+<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
Image:
Ependymoma-lateral-ventricle(9).jpg|DWI<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
</gallery>
''Note'':There is a large left frontal mixed cystic/solid lesion, measuring approximately 4x4x5cm in perpendicular dimensions, with intralesional haemorrhage and fluid level which may indicate areas of necrosis. Large surrounding vasogenic edema involving the contralateral hemisphere, and significant mass effect causing almost 2cm midline shift, obstructing the monro foramina resulting moderate non-communicating hydrocephalus.

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma physical examination

2015-10-16T13:19:10Z

Ahmad Al Maradni: /* HEENT */

__NOTOC__
{{Ependymoma}}
{{CMG}} {{AE}} {{AAM}}
==Overview==
Patients with ependymoma usually appear well. Physical examination of patients with ependymoma is usually remarkable for [[altered mental status]], [[spasticity]], and [[muscle weakness]].
==Physical Examination==
Common physical examination findings of ependymoma include:<ref name="pmid22056760">{{cite journal| author=Radhakrishnan N, Nair NS, Hingwala DR, Kapilamoorthy TR, Radhakrishnan VV| title=Tanycytic ependymoma of filum terminale: a case report. | journal=Clin Neurol Neurosurg | year= 2012 | volume= 114 | issue= 2 | pages= 169-71 | pmid=22056760 | doi=10.1016/j.clineuro.2011.09.017 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22056760 }} </ref>

===Neurological===
*[[Altered mental status]]
*[[Ataxia]]
*Focal neurological deficits
**[[Corticospinal tract|Corticospinal tract defect]]
***[[Spasticity]]
***[[Hyperreflexia]]
***Loss of the ability to perform fine movements
***Extensor plantar response ([[Babinski sign]] present)
**[[spinocerebellar tract|Spinocerebellar tract defect]]
**[[nerve palsy|Cranioneuropathies]]

===Musculoskeletal===
*[[Muscle weakness]]
*Bladder dysfunction
*Low back pain

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma physical examination

2015-10-16T13:18:12Z

Ahmad Al Maradni: /* Neurological */

__NOTOC__
{{Ependymoma}}
{{CMG}} {{AE}} {{AAM}}
==Overview==
Patients with ependymoma usually appear well. Physical examination of patients with ependymoma is usually remarkable for [[altered mental status]], [[spasticity]], and [[muscle weakness]].
==Physical Examination==
Common physical examination findings of ependymoma include:<ref name="pmid22056760">{{cite journal| author=Radhakrishnan N, Nair NS, Hingwala DR, Kapilamoorthy TR, Radhakrishnan VV| title=Tanycytic ependymoma of filum terminale: a case report. | journal=Clin Neurol Neurosurg | year= 2012 | volume= 114 | issue= 2 | pages= 169-71 | pmid=22056760 | doi=10.1016/j.clineuro.2011.09.017 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22056760 }} </ref>

===HEENT===
*Sudden onset of disc edema, [[esotropia]], and field loss.

===Neurological===
*[[Altered mental status]]
*[[Ataxia]]
*Focal neurological deficits
**[[Corticospinal tract|Corticospinal tract defect]]
***[[Spasticity]]
***[[Hyperreflexia]]
***Loss of the ability to perform fine movements
***Extensor plantar response ([[Babinski sign]] present)
**[[spinocerebellar tract|Spinocerebellar tract defect]]
**[[nerve palsy|Cranioneuropathies]]

===Musculoskeletal===
*[[Muscle weakness]]
*Bladder dysfunction
*Low back pain

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma physical examination

2015-10-16T13:16:44Z

Ahmad Al Maradni: /* Musculoskeletal */

__NOTOC__
{{Ependymoma}}
{{CMG}} {{AE}} {{AAM}}
==Overview==
Patients with ependymoma usually appear well. Physical examination of patients with ependymoma is usually remarkable for [[altered mental status]], [[spasticity]], and [[muscle weakness]].
==Physical Examination==
Common physical examination findings of ependymoma include:<ref name="pmid22056760">{{cite journal| author=Radhakrishnan N, Nair NS, Hingwala DR, Kapilamoorthy TR, Radhakrishnan VV| title=Tanycytic ependymoma of filum terminale: a case report. | journal=Clin Neurol Neurosurg | year= 2012 | volume= 114 | issue= 2 | pages= 169-71 | pmid=22056760 | doi=10.1016/j.clineuro.2011.09.017 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22056760 }} </ref>

===HEENT===
*Sudden onset of disc edema, [[esotropia]], and field loss.

===Neurological===
*[[Altered mental status]]
*Focal neurological deficits
**[[Corticospinal tract|Corticospinal tract defect]]
***[[Spasticity]]
***[[Hyperreflexia]]
***Loss of the ability to perform fine movements
***Extensor plantar response ([[Babinski sign]] present)
**[[spinocerebellar tract|Spinocerebellar tract defect]]
***[[proprioception|Loss of proprioception]]
**[[nerve palsy|Cranioneuropathies]]
***Bilateral [[Oculomotor nerve palsy|3rd cranial nerve palsy]]
===Musculoskeletal===
*[[Muscle weakness]]
*Bladder dysfunction
*Low back pain

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma history and symptoms

2015-10-16T13:14:28Z

Ahmad Al Maradni: /* Spinal cord ependymoma */

__NOTOC__
{{Ependymoma}}
{{CMG}} {{AE}} {{AAM}}
==Overview==
Symptoms of ependymoma include [[headache]], [[nausea]], and [[irritability]].
==History and Symptoms==
===Infratentorial (posterior fossa) ependymoma===
* [[Headache]]
* [[Nausea]]
* [[Vomiting]]
* Blurry or [[double vision]]
* [[Drowsiness]] (after several hours of the above symptoms)
* [[Irritability]]
* [[Ataxia]]
* Neck pain
* [[Cranial nerve palsies]]

===Supratentorial ependymoma===
*[[Headache]]
*[[Seizures]]
*Focal neurologic deficits.

===Spinal cord ependymoma===
*[[Back pain]]
*Lower extremity weakness
*Bowel and bladder dysfunction

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma natural history

2015-10-16T13:13:10Z

Ahmad Al Maradni: /* Prognosis */

__NOTOC__
{{Ependymoma}}
{{CMG}} {{AE}} {{AAM}}
==Overview==
If left untreated, patients with ependymoma may progress to develop [[nausea]], [[vomiting]], [[headache]], and [[irritability]]. Common complications of ependymoma include [[seizure]], [[hydrocephalus]], [[paralysis|muscle paralysis]], and [[speech problems]].
==Complication==
Common complications associated with ependymomas are:
*[[Depression]]
*[[Seizures]]
*[[Hydrocephalus]]
*[[Hearing loss]]
*[[Speech problems]]
*[[paralysis|Muscle paralysis]]
==Prognosis==
Unfavorable factors affecting outcome include the following:<ref name=Cancergove> Eoendymoma. http://www.cancer.gov/types/brain/hp/child-ependymoma-treatment-pdq#section/_35 URL Accessed on 10 6 2015.</ref>

*Gain of ''chromosome 1q25'' is present in approximately 20% of pediatric intracranial ependymoma cases and has been reported as a negative [[prognostic|prognostic factor]] by multiple research groups.<ref name="pmid22526017">{{cite journal| author=Godfraind C, Kaczmarska JM, Kocak M, Dalton J, Wright KD, Sanford RA et al.| title=Distinct disease-risk groups in pediatric supratentorial and posterior fossa ependymomas. | journal=Acta Neuropathol | year= 2012 | volume= 124 | issue= 2 | pages= 247-57 | pmid=22526017 | doi=10.1007/s00401-012-0981-9 | pmc=PMC3554251 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22526017 }} </ref><ref name="pmid16609018">{{cite journal| author=Mendrzyk F, Korshunov A, Benner A, Toedt G, Pfister S, Radlwimmer B et al.| title=Identification of gains on 1q and epidermal growth factor receptor overexpression as independent prognostic markers in intracranial ependymoma. | journal=Clin Cancer Res | year= 2006 | volume= 12 | issue= 7 Pt 1 | pages= 2070-9 | pmid=16609018 | doi=10.1158/1078-0432.CCR-05-2363 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16609018 }} </ref>
*[[Gene expression]] profile<ref name="pmid22322993">{{cite journal| author=Wani K, Armstrong TS, Vera-Bolanos E, Raghunathan A, Ellison D, Gilbertson R et al.| title=A prognostic gene expression signature in infratentorial ependymoma. | journal=Acta Neuropathol | year= 2012 | volume= 123 | issue= 5 | pages= 727-38 | pmid=22322993 | doi=10.1007/s00401-012-0941-4 | pmc=PMC4013829 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22322993 }} </ref>

*Other factors that have been reported to be associated with poor prognosis for pediatric ependymoma include expression of the enzymatic subunit of [[telomerase]] (hTERT) and expression of the neural stem cell marker Nestin.<ref name="pmid16575002">{{cite journal| author=Tabori U, Ma J, Carter M, Zielenska M, Rutka J, Bouffet E et al.| title=Human telomere reverse transcriptase expression predicts progression and survival in pediatric intracranial ependymoma. | journal=J Clin Oncol | year= 2006 | volume= 24 | issue= 10 | pages= 1522-8 | pmid=16575002 | doi=10.1200/JCO.2005.04.2127 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16575002 }} </ref><ref name="pmid23076205">{{cite journal| author=Modena P, Buttarelli FR, Miceli R, Piccinin E, Baldi C, Antonelli M et al.| title=Predictors of outcome in an AIEOP series of childhood ependymomas: a multifactorial analysis. | journal=Neuro Oncol | year= 2012 | volume= 14 | issue= 11 | pages= 1346-56 | pmid=23076205 | doi=10.1093/neuonc/nos245 | pmc=PMC3480268 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23076205 }} </ref>

*Tumor location. Cranial variants of ependymoma have a less favorable outcome than primary [[spinal cord]] ependymomas. Location within the spinal cord may also affect outcome, with tumors in the lower portion of the spinal cord having a worse prognosis.<ref name="pmid23259510">{{cite journal| author=Oh MC, Sayegh ET, Safaee M, Sun MZ, Kaur G, Kim JM et al.| title=Prognosis by tumor location for pediatric spinal cord ependymomas. | journal=J Neurosurg Pediatr | year= 2013 | volume= 11 | issue= 3 | pages= 282-8 | pmid=23259510 | doi=10.3171/2012.11.PEDS12292 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23259510 }} </ref>
*Younger age at diagnosis.<ref name="pmid19387655">{{cite journal| author=Tamburrini G, D'Ercole M, Pettorini BL, Caldarelli M, Massimi L, Di Rocco C| title=Survival following treatment for intracranial ependymoma: a review. | journal=Childs Nerv Syst | year= 2009 | volume= 25 | issue= 10 | pages= 1303-12 | pmid=19387655 | doi=10.1007/s00381-009-0874-y | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19387655 }} </ref>
*[[Anaplastic|Anaplastic histology]]<ref name="pmid15022291">{{cite journal| author=Korshunov A, Golanov A, Sycheva R, Timirgaz V| title=The histologic grade is a main prognostic factor for patients with intracranial ependymomas treated in the microneurosurgical era: an analysis of 258 patients. | journal=Cancer | year= 2004 | volume= 100 | issue= 6 | pages= 1230-7 | pmid=15022291 | doi=10.1002/cncr.20075 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15022291 }} </ref>
*Subtotal resection<ref name="pmid1303-12">{{cite journal| author=White F| title=Epidemiology and infection control. | journal=Dimens Health Serv | year= 1975 | volume= 52 | issue= 12 | pages= 34, 37, 39 | pmid=1303-12 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1303 }} </ref>
*Lower doses of [[radiation]]<ref name="pmid22840355">{{cite journal| author=Vaidya K, Smee R, Williams JR| title=Prognostic factors and treatment options for paediatric ependymomas. | journal=J Clin Neurosci | year= 2012 | volume= 19 | issue= 9 | pages= 1228-35 | pmid=22840355 | doi=10.1016/j.jocn.2012.02.006 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22840355 }} </ref>
*Immunohistochemical testing has identified increased expression of markers of proliferation (e.g., ''Ki-67'' and ''MIB-1'') and increased expression of ''[[EZH2]]'', a polycomb complex protein involved in epigenetic regulation of gene expression, as prognostic factors for greater risk of treatment failure.<ref name="pmid25586788">{{cite journal| author=Li AM, Dunham C, Tabori U, Carret AS, McNeely PD, Johnston D et al.| title=EZH2 expression is a prognostic factor in childhood intracranial ependymoma: a Canadian Pediatric Brain Tumor Consortium study. | journal=Cancer | year= 2015 | volume= 121 | issue= 9 | pages= 1499-507 | pmid=25586788 | doi=10.1002/cncr.29198 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25586788 }} </ref><ref name="pmid15223962">{{cite journal| author=Wolfsberger S, Fischer I, Höftberger R, Birner P, Slavc I, Dieckmann K et al.| title=Ki-67 immunolabeling index is an accurate predictor of outcome in patients with intracranial ependymoma. | journal=Am J Surg Pathol | year= 2004 | volume= 28 | issue= 7 | pages= 914-20 | pmid=15223962 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15223962 }} </ref><ref name="pmid16342252">{{cite journal| author=Kurt E, Zheng PP, Hop WC, van der Weiden M, Bol M, van den Bent MJ et al.| title=Identification of relevant prognostic histopathologic features in 69 intracranial ependymomas, excluding myxopapillary ependymomas and subependymomas. | journal=Cancer | year= 2006 | volume= 106 | issue= 2 | pages= 388-95 | pmid=16342252 | doi=10.1002/cncr.21608 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16342252 }} </ref>

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma natural history

2015-10-16T13:11:52Z

Ahmad Al Maradni: /* Prognosis */

__NOTOC__
{{Ependymoma}}
{{CMG}} {{AE}} {{AAM}}
==Overview==
If left untreated, patients with ependymoma may progress to develop [[nausea]], [[vomiting]], [[headache]], and [[irritability]]. Common complications of ependymoma include [[seizure]], [[hydrocephalus]], [[paralysis|muscle paralysis]], and [[speech problems]].
==Complication==
Common complications associated with ependymomas are:
*[[Depression]]
*[[Seizures]]
*[[Hydrocephalus]]
*[[Hearing loss]]
*[[Speech problems]]
*[[paralysis|Muscle paralysis]]
==Prognosis==
Unfavorable factors affecting outcome include the following:<ref name=Cancergove> Eoendymoma. http://www.cancer.gov/types/brain/hp/child-ependymoma-treatment-pdq#section/_35 URL Accessed on 10 6 2015.</ref>

*Gain of ''chromosome 1q25'' is present in approximately 20% of pediatric intracranial ependymoma cases and has been reported as a negative [[prognostic|prognostic factor]] by multiple research groups.<ref name="pmid22526017">{{cite journal| author=Godfraind C, Kaczmarska JM, Kocak M, Dalton J, Wright KD, Sanford RA et al.| title=Distinct disease-risk groups in pediatric supratentorial and posterior fossa ependymomas. | journal=Acta Neuropathol | year= 2012 | volume= 124 | issue= 2 | pages= 247-57 | pmid=22526017 | doi=10.1007/s00401-012-0981-9 | pmc=PMC3554251 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22526017 }} </ref><ref name="pmid16609018">{{cite journal| author=Mendrzyk F, Korshunov A, Benner A, Toedt G, Pfister S, Radlwimmer B et al.| title=Identification of gains on 1q and epidermal growth factor receptor overexpression as independent prognostic markers in intracranial ependymoma. | journal=Clin Cancer Res | year= 2006 | volume= 12 | issue= 7 Pt 1 | pages= 2070-9 | pmid=16609018 | doi=10.1158/1078-0432.CCR-05-2363 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16609018 }} </ref>
*[[Gene expression]] profile<ref name="pmid22322993">{{cite journal| author=Wani K, Armstrong TS, Vera-Bolanos E, Raghunathan A, Ellison D, Gilbertson R et al.| title=A prognostic gene expression signature in infratentorial ependymoma. | journal=Acta Neuropathol | year= 2012 | volume= 123 | issue= 5 | pages= 727-38 | pmid=22322993 | doi=10.1007/s00401-012-0941-4 | pmc=PMC4013829 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22322993 }} </ref>

*Other factors that have been reported to be associated with poor prognosis for pediatric ependymoma include expression of the enzymatic subunit of [[telomerase]] (hTERT) and expression of the neural stem cell marker Nestin.<ref name="pmid16575002">{{cite journal| author=Tabori U, Ma J, Carter M, Zielenska M, Rutka J, Bouffet E et al.| title=Human telomere reverse transcriptase expression predicts progression and survival in pediatric intracranial ependymoma. | journal=J Clin Oncol | year= 2006 | volume= 24 | issue= 10 | pages= 1522-8 | pmid=16575002 | doi=10.1200/JCO.2005.04.2127 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16575002 }} </ref><ref name="pmid23076205">{{cite journal| author=Modena P, Buttarelli FR, Miceli R, Piccinin E, Baldi C, Antonelli M et al.| title=Predictors of outcome in an AIEOP series of childhood ependymomas: a multifactorial analysis. | journal=Neuro Oncol | year= 2012 | volume= 14 | issue= 11 | pages= 1346-56 | pmid=23076205 | doi=10.1093/neuonc/nos245 | pmc=PMC3480268 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23076205 }} </ref>

*Tumor location. Cranial variants of ependymoma have a less favorable outcome than primary [[spinal cord]] ependymomas. Location within the spinal cord may also affect outcome, with tumors in the lower portion of the spinal cord having a worse prognosis.<ref name="pmid23259510">{{cite journal| author=Oh MC, Sayegh ET, Safaee M, Sun MZ, Kaur G, Kim JM et al.| title=Prognosis by tumor location for pediatric spinal cord ependymomas. | journal=J Neurosurg Pediatr | year= 2013 | volume= 11 | issue= 3 | pages= 282-8 | pmid=23259510 | doi=10.3171/2012.11.PEDS12292 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23259510 }} </ref>
*Younger age at diagnosis.<ref name="pmid19387655">{{cite journal| author=Tamburrini G, D'Ercole M, Pettorini BL, Caldarelli M, Massimi L, Di Rocco C| title=Survival following treatment for intracranial ependymoma: a review. | journal=Childs Nerv Syst | year= 2009 | volume= 25 | issue= 10 | pages= 1303-12 | pmid=19387655 | doi=10.1007/s00381-009-0874-y | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19387655 }} </ref>
*[[Anaplastic|Anaplastic histology]]<ref name="pmid15022291">{{cite journal| author=Korshunov A, Golanov A, Sycheva R, Timirgaz V| title=The histologic grade is a main prognostic factor for patients with intracranial ependymomas treated in the microneurosurgical era: an analysis of 258 patients. | journal=Cancer | year= 2004 | volume= 100 | issue= 6 | pages= 1230-7 | pmid=15022291 | doi=10.1002/cncr.20075 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15022291 }} </ref>
*Subtotal resection<ref name="pmid1303-12">{{cite journal| author=White F| title=Epidemiology and infection control. | journal=Dimens Health Serv | year= 1975 | volume= 52 | issue= 12 | pages= 34, 37, 39 | pmid=1303-12 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1303 }} </ref>
*Lower doses of [[radiation]]<ref name="pmid22840355">{{cite journal| author=Vaidya K, Smee R, Williams JR| title=Prognostic factors and treatment options for paediatric ependymomas. | journal=J Clin Neurosci | year= 2012 | volume= 19 | issue= 9 | pages= 1228-35 | pmid=22840355 | doi=10.1016/j.jocn.2012.02.006 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22840355 }} </ref>
*Immunohistochemical testing has identified increased expression of markers of proliferation (e.g., ''Ki-67'' and ''MIB-1'')<ref name="pmid15223962">{{cite journal| author=Wolfsberger S, Fischer I, Höftberger R, Birner P, Slavc I, Dieckmann K et al.| title=Ki-67 immunolabeling index is an accurate predictor of outcome in patients with intracranial ependymoma. | journal=Am J Surg Pathol | year= 2004 | volume= 28 | issue= 7 | pages= 914-20 | pmid=15223962 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15223962 }} </ref><ref name="pmid16342252">{{cite journal| author=Kurt E, Zheng PP, Hop WC, van der Weiden M, Bol M, van den Bent MJ et al.| title=Identification of relevant prognostic histopathologic features in 69 intracranial ependymomas, excluding myxopapillary ependymomas and subependymomas. | journal=Cancer | year= 2006 | volume= 106 | issue= 2 | pages= 388-95 | pmid=16342252 | doi=10.1002/cncr.21608 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16342252 }} </ref> and increased expression of ''[[EZH2]]'', a polycomb complex protein involved in epigenetic regulation of gene expression, as prognostic factors for greater risk of treatment failure.<ref name="pmid25586788">{{cite journal| author=Li AM, Dunham C, Tabori U, Carret AS, McNeely PD, Johnston D et al.| title=EZH2 expression is a prognostic factor in childhood intracranial ependymoma: a Canadian Pediatric Brain Tumor Consortium study. | journal=Cancer | year= 2015 | volume= 121 | issue= 9 | pages= 1499-507 | pmid=25586788 | doi=10.1002/cncr.29198 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25586788 }} </ref>

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma natural history

2015-10-16T13:11:10Z

Ahmad Al Maradni: /* Natural History, Complication and Prognosis */

__NOTOC__
{{Ependymoma}}
{{CMG}} {{AE}} {{AAM}}
==Overview==
If left untreated, patients with ependymoma may progress to develop [[nausea]], [[vomiting]], [[headache]], and [[irritability]]. Common complications of ependymoma include [[seizure]], [[hydrocephalus]], [[paralysis|muscle paralysis]], and [[speech problems]].
==Complication==
Common complications associated with ependymomas are:
*[[Depression]]
*[[Seizures]]
*[[Hydrocephalus]]
*[[Hearing loss]]
*[[Speech problems]]
*[[paralysis|Muscle paralysis]]
==Prognosis==
Unfavorable factors affecting outcome include the following:<ref name=Cancergove> Eoendymoma. http://www.cancer.gov/types/brain/hp/child-ependymoma-treatment-pdq#section/_35 URL Accessed on 10 6 2015.</ref>

*Gain of ''chromosome 1q25'' is present in approximately 20% of pediatric intracranial ependymoma cases and has been reported as a negative [[prognostic|prognostic factor]] by multiple research groups.<ref name="pmid22526017">{{cite journal| author=Godfraind C, Kaczmarska JM, Kocak M, Dalton J, Wright KD, Sanford RA et al.| title=Distinct disease-risk groups in pediatric supratentorial and posterior fossa ependymomas. | journal=Acta Neuropathol | year= 2012 | volume= 124 | issue= 2 | pages= 247-57 | pmid=22526017 | doi=10.1007/s00401-012-0981-9 | pmc=PMC3554251 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22526017 }} </ref><ref name="pmid16609018">{{cite journal| author=Mendrzyk F, Korshunov A, Benner A, Toedt G, Pfister S, Radlwimmer B et al.| title=Identification of gains on 1q and epidermal growth factor receptor overexpression as independent prognostic markers in intracranial ependymoma. | journal=Clin Cancer Res | year= 2006 | volume= 12 | issue= 7 Pt 1 | pages= 2070-9 | pmid=16609018 | doi=10.1158/1078-0432.CCR-05-2363 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16609018 }} </ref>
*[[Gene expression]] profile.<ref name="pmid22322993">{{cite journal| author=Wani K, Armstrong TS, Vera-Bolanos E, Raghunathan A, Ellison D, Gilbertson R et al.| title=A prognostic gene expression signature in infratentorial ependymoma. | journal=Acta Neuropathol | year= 2012 | volume= 123 | issue= 5 | pages= 727-38 | pmid=22322993 | doi=10.1007/s00401-012-0941-4 | pmc=PMC4013829 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22322993 }} </ref>

*Other factors that have been reported to be associated with poor prognosis for pediatric ependymoma include expression of the enzymatic subunit of [[telomerase]] (hTERT) and expression of the neural stem cell marker Nestin.<ref name="pmid16575002">{{cite journal| author=Tabori U, Ma J, Carter M, Zielenska M, Rutka J, Bouffet E et al.| title=Human telomere reverse transcriptase expression predicts progression and survival in pediatric intracranial ependymoma. | journal=J Clin Oncol | year= 2006 | volume= 24 | issue= 10 | pages= 1522-8 | pmid=16575002 | doi=10.1200/JCO.2005.04.2127 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16575002 }} </ref><ref name="pmid23076205">{{cite journal| author=Modena P, Buttarelli FR, Miceli R, Piccinin E, Baldi C, Antonelli M et al.| title=Predictors of outcome in an AIEOP series of childhood ependymomas: a multifactorial analysis. | journal=Neuro Oncol | year= 2012 | volume= 14 | issue= 11 | pages= 1346-56 | pmid=23076205 | doi=10.1093/neuonc/nos245 | pmc=PMC3480268 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23076205 }} </ref>

*Tumor location. Cranial variants of ependymoma have a less favorable outcome than primary [[spinal cord]] ependymomas. Location within the spinal cord may also affect outcome, with tumors in the lower portion of the spinal cord having a worse prognosis.<ref name="pmid23259510">{{cite journal| author=Oh MC, Sayegh ET, Safaee M, Sun MZ, Kaur G, Kim JM et al.| title=Prognosis by tumor location for pediatric spinal cord ependymomas. | journal=J Neurosurg Pediatr | year= 2013 | volume= 11 | issue= 3 | pages= 282-8 | pmid=23259510 | doi=10.3171/2012.11.PEDS12292 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23259510 }} </ref>
*Younger age at diagnosis.<ref name="pmid19387655">{{cite journal| author=Tamburrini G, D'Ercole M, Pettorini BL, Caldarelli M, Massimi L, Di Rocco C| title=Survival following treatment for intracranial ependymoma: a review. | journal=Childs Nerv Syst | year= 2009 | volume= 25 | issue= 10 | pages= 1303-12 | pmid=19387655 | doi=10.1007/s00381-009-0874-y | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19387655 }} </ref>
*[[Anaplastic|Anaplastic histology]].<ref name="pmid15022291">{{cite journal| author=Korshunov A, Golanov A, Sycheva R, Timirgaz V| title=The histologic grade is a main prognostic factor for patients with intracranial ependymomas treated in the microneurosurgical era: an analysis of 258 patients. | journal=Cancer | year= 2004 | volume= 100 | issue= 6 | pages= 1230-7 | pmid=15022291 | doi=10.1002/cncr.20075 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15022291 }} </ref>
*Subtotal resection.<ref name="pmid1303-12">{{cite journal| author=White F| title=Epidemiology and infection control. | journal=Dimens Health Serv | year= 1975 | volume= 52 | issue= 12 | pages= 34, 37, 39 | pmid=1303-12 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1303 }} </ref>
*Lower doses of [[radiation]].<ref name="pmid22840355">{{cite journal| author=Vaidya K, Smee R, Williams JR| title=Prognostic factors and treatment options for paediatric ependymomas. | journal=J Clin Neurosci | year= 2012 | volume= 19 | issue= 9 | pages= 1228-35 | pmid=22840355 | doi=10.1016/j.jocn.2012.02.006 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22840355 }} </ref>
*Immunohistochemical testing has identified increased expression of markers of proliferation (e.g., ''Ki-67'' and ''MIB-1'')<ref name="pmid15223962">{{cite journal| author=Wolfsberger S, Fischer I, Höftberger R, Birner P, Slavc I, Dieckmann K et al.| title=Ki-67 immunolabeling index is an accurate predictor of outcome in patients with intracranial ependymoma. | journal=Am J Surg Pathol | year= 2004 | volume= 28 | issue= 7 | pages= 914-20 | pmid=15223962 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15223962 }} </ref><ref name="pmid16342252">{{cite journal| author=Kurt E, Zheng PP, Hop WC, van der Weiden M, Bol M, van den Bent MJ et al.| title=Identification of relevant prognostic histopathologic features in 69 intracranial ependymomas, excluding myxopapillary ependymomas and subependymomas. | journal=Cancer | year= 2006 | volume= 106 | issue= 2 | pages= 388-95 | pmid=16342252 | doi=10.1002/cncr.21608 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16342252 }} </ref> and increased expression of ''[[EZH2]]'', a polycomb complex protein involved in epigenetic regulation of gene expression, as prognostic factors for greater risk of treatment failure.<ref name="pmid25586788">{{cite journal| author=Li AM, Dunham C, Tabori U, Carret AS, McNeely PD, Johnston D et al.| title=EZH2 expression is a prognostic factor in childhood intracranial ependymoma: a Canadian Pediatric Brain Tumor Consortium study. | journal=Cancer | year= 2015 | volume= 121 | issue= 9 | pages= 1499-507 | pmid=25586788 | doi=10.1002/cncr.29198 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25586788 }} </ref>

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma differential diagnosis

2015-10-16T13:03:50Z

Ahmad Al Maradni: /* Differentiating ependymoma from other diseases */

__NOTOC__
{{Ependymoma}}
{{CMG}} {{AE}} {{AAM}}

==Overview==
Ependymoma must be differentiated from [[medulloblastoma]], [[choroid plexus papilloma]], and [[glioblastoma]].
==Differentiating ependymoma from other diseases==
*Ependymoma can not be differentiated from other [[brain tumor]]s clinically, [[biopsy]] is required for definitive diagnosis.

*Differential diagnoses of ependymoma include other intracranial tumors, such as:
:*[[Medulloblastoma]]
:*[[Choroid plexus papilloma]]
:*[[Choroid plexus|Choroid plexus metastasis]]
:*[[Glioblastoma]]
:*Central neurocytoma

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma risk factors

2015-10-16T12:59:20Z

Ahmad Al Maradni: /* Risk Factors */

__NOTOC__
{{Ependymoma}}
{{CMG}} {{AE}} {{AAM}}
==Overview==
Common risk factors in the development of ependymoma are certain hereditary diseases ([[neurofibromatosis]] type II and Turcot syndrome), over-expression of [[kinetochore]] proteins, and down-regulation of [[metallothionein|metallothioneins]].

==Risk Factors==
* Children with certain hereditary diseases, such as [[neurofibromatosis type II]] (NF2), [[Turcot syndrome]] B, and [[MEN1 syndrome]], have been found to be more frequently afflicted with ependymal tumors.
* Increased occurrence of ''chromosome 1q'' and proteins such as [[tenascin C]] and [[epidermal growth factor]] are associated with increased risk for developing ependymal tumors.
*''ERBB2'', ''ERBB4'', and human telomerase reverse transcriptase ''TERT'' gene expression promote tumor cell proliferation, contributing to aggressive tumor behavior.<ref name=Wikipedia> Ependymoma https://en.wikipedia.org/wiki/Pediatric_ependymoma#Cell_of_origin. URL Accessed on 10 08 2015</ref>
*High expression of epidermal growth factor receptor ''EGFR'' correlates with unfavorable outcome.<ref name="pmid16609018">{{cite journal| author=Mendrzyk F, Korshunov A, Benner A, Toedt G, Pfister S, Radlwimmer B et al.| title=Identification of gains on 1q and epidermal growth factor receptor overexpression as independent prognostic markers in intracranial ependymoma. | journal=Clin Cancer Res | year= 2006 | volume= 12 | issue= 7 Pt 1 | pages= 2070-9 | pmid=16609018 | doi=10.1158/1078-0432.CCR-05-2363 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16609018 }} </ref>
*Over-expression of [[kinetochore]] proteins and down-regulation of [[metallothionein|metallothioneins]] are associated with recurrence of ependymomas.<ref name="pmid20885975">{{cite journal| author=Peyre M, Commo F, Dantas-Barbosa C, Andreiuolo F, Puget S, Lacroix L et al.| title=Portrait of ependymoma recurrence in children: biomarkers of tumor progression identified by dual-color microarray-based gene expression analysis. | journal=PLoS One | year= 2010 | volume= 5 | issue= 9 | pages= e12932 | pmid=20885975 | doi=10.1371/journal.pone.0012932 | pmc=PMC2945762 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20885975 }} </ref>

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma epidemiology and demographics

2015-10-16T12:55:10Z

Ahmad Al Maradni: /* Overview */

__NOTOC__
{{Ependymoma}}

{{CMG}} {{AE}} {{AAM}}

==Overview==
The incidence of ependymoma is approximately 0.05 to 0.08 per 100,000 individuals in the United States.<ref name="cancergov">National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/publications/pdq</ref> The posterior fossa tumours tend to present more commonly in the paediatric age group (mean age at diagnosis is 6 years of age). Male and female are affected equally by ependymomal tumors.<ref name=radio>.Ependymomas Dr Bruno Di Muzio and Dr Frank Gaillard Gold Supporter since June 24, 2015. Radiopaedia.org 2015.http://radiopaedia.org/articles/ependymoma. URL Accessed on 10/12/2015</ref>

==Epidemiology and Demographics==
===Incidence===
*The incidence of ependymoma is approximately 0.05 to 0.08 per 100,000 individuals in the United States.<ref name="cancergov">National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/publications/pdq</ref>
===Age===
* The posterior fossa tumors tend to present more commonly among the paediatric age group (mean age at diagnosis is 6 years of age).
* Subependymoma usually affects people older than 40 years of age.

===Gender===
*Males and females are affected equally by ependymomal tumors.<ref name=radio>.Ependymomas Dr Bruno Di Muzio and Dr Frank Gaillard Gold Supporter since June 24, 2015">. Radiopaedia.org 2015.http://radiopaedia.org/articles/ependymoma</ref>
* Subependymoma more often affects men than women.

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma epidemiology and demographics

2015-10-16T12:52:17Z

Ahmad Al Maradni: /* Age */

__NOTOC__
{{Ependymoma}}

{{CMG}} {{AE}} {{AAM}}

==Overview==
The incidence of ependymoma is approximately 0.05 to 0.08 per 100,000 individuals in the United States.<ref name="cancergov">National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/publications/pdq</ref> The posterior fossa tumours tend to present more commonly in the paediatric age group (mean age at diagnosis is 6 years of age). Male and female are affected equally by ependymomal tumors.<ref name=radio>.Ependymomas Dr Bruno Di Muzio and Dr Frank Gaillard Gold Supporter since June 24, 2015">. Radiopaedia.org 2015.http://radiopaedia.org/articles/ependymoma</ref>

==Epidemiology and Demographics==
===Incidence===
*The incidence of ependymoma is approximately 0.05 to 0.08 per 100,000 individuals in the United States.<ref name="cancergov">National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/publications/pdq</ref>
===Age===
* The posterior fossa tumors tend to present more commonly among the paediatric age group (mean age at diagnosis is 6 years of age).
* Subependymoma usually affects people older than 40 years of age.

===Gender===
*Males and females are affected equally by ependymomal tumors.<ref name=radio>.Ependymomas Dr Bruno Di Muzio and Dr Frank Gaillard Gold Supporter since June 24, 2015">. Radiopaedia.org 2015.http://radiopaedia.org/articles/ependymoma</ref>
* Subependymoma more often affects men than women.

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma epidemiology and demographics

2015-10-16T12:51:55Z

Ahmad Al Maradni: /* Gender */

__NOTOC__
{{Ependymoma}}

{{CMG}} {{AE}} {{AAM}}

==Overview==
The incidence of ependymoma is approximately 0.05 to 0.08 per 100,000 individuals in the United States.<ref name="cancergov">National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/publications/pdq</ref> The posterior fossa tumours tend to present more commonly in the paediatric age group (mean age at diagnosis is 6 years of age). Male and female are affected equally by ependymomal tumors.<ref name=radio>.Ependymomas Dr Bruno Di Muzio and Dr Frank Gaillard Gold Supporter since June 24, 2015">. Radiopaedia.org 2015.http://radiopaedia.org/articles/ependymoma</ref>

==Epidemiology and Demographics==
===Incidence===
*The incidence of ependymoma is approximately 0.05 to 0.08 per 100,000 individuals in the United States.<ref name="cancergov">National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/publications/pdq</ref>
===Age===
* The posterior fossa tumors tend to present more commonly among the paediatric age group (mean age at diagnosis is 6 years of age)
* Subependymoma usually affects people older than 40 years of age.

===Gender===
*Males and females are affected equally by ependymomal tumors.<ref name=radio>.Ependymomas Dr Bruno Di Muzio and Dr Frank Gaillard Gold Supporter since June 24, 2015">. Radiopaedia.org 2015.http://radiopaedia.org/articles/ependymoma</ref>
* Subependymoma more often affects men than women.

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma epidemiology and demographics

2015-10-16T12:50:31Z

Ahmad Al Maradni: /* Overview */

__NOTOC__
{{Ependymoma}}

{{CMG}} {{AE}} {{AAM}}

==Overview==
The incidence of ependymoma is approximately 0.05 to 0.08 per 100,000 individuals in the United States.<ref name="cancergov">National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/publications/pdq</ref> The posterior fossa tumours tend to present more commonly in the paediatric age group (mean age at diagnosis is 6 years of age). Male and female are affected equally by ependymomal tumors.<ref name=radio>.Ependymomas Dr Bruno Di Muzio and Dr Frank Gaillard Gold Supporter since June 24, 2015">. Radiopaedia.org 2015.http://radiopaedia.org/articles/ependymoma</ref>

==Epidemiology and Demographics==
===Incidence===
*The incidence of ependymoma is approximately 0.05 to 0.08 per 100,000 individuals in the United States.<ref name="cancergov">National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/publications/pdq</ref>
===Age===
* The posterior fossa tumors tend to present more commonly among the paediatric age group (mean age at diagnosis is 6 years of age)
* Subependymoma usually affects people older than 40 years of age.

===Gender===
*Males and females are affected equally by ependymomal tumors<ref name=radio>.Ependymomas Dr Bruno Di Muzio and Dr Frank Gaillard Gold Supporter since June 24, 2015">. Radiopaedia.org 2015.http://radiopaedia.org/articles/ependymoma</ref>
* Subependymoma more often affects men than women.

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma epidemiology and demographics

2015-10-16T12:48:06Z

Ahmad Al Maradni: /* Gender */

__NOTOC__
{{Ependymoma}}

{{CMG}} {{AE}} {{AAM}}

==Overview==
The incidence of ependymoma is approximately 0.05 to 0.08 per 100,000 individuals in the United States.<ref name="cancergov">National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/publications/pdq</ref> The posterior fossa tumours tend to present more commonly in the paediatric age group (mean age at diagnosis is 6 years of age). Male and Female are affected equally by ependymomal tumors<ref name=radio>.Ependymomas Dr Bruno Di Muzio and Dr Frank Gaillard Gold Supporter since June 24, 2015">. Radiopaedia.org 2015.http://radiopaedia.org/articles/ependymoma</ref>

==Epidemiology and Demographics==
===Incidence===
*The incidence of ependymoma is approximately 0.05 to 0.08 per 100,000 individuals in the United States.<ref name="cancergov">National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/publications/pdq</ref>
===Age===
* The posterior fossa tumors tend to present more commonly among the paediatric age group (mean age at diagnosis is 6 years of age)
* Subependymoma usually affects people older than 40 years of age.

===Gender===
*Males and females are affected equally by ependymomal tumors<ref name=radio>.Ependymomas Dr Bruno Di Muzio and Dr Frank Gaillard Gold Supporter since June 24, 2015">. Radiopaedia.org 2015.http://radiopaedia.org/articles/ependymoma</ref>
* Subependymoma more often affects men than women.

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma epidemiology and demographics

2015-10-16T12:47:35Z

Ahmad Al Maradni: /* Age */

__NOTOC__
{{Ependymoma}}

{{CMG}} {{AE}} {{AAM}}

==Overview==
The incidence of ependymoma is approximately 0.05 to 0.08 per 100,000 individuals in the United States.<ref name="cancergov">National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/publications/pdq</ref> The posterior fossa tumours tend to present more commonly in the paediatric age group (mean age at diagnosis is 6 years of age). Male and Female are affected equally by ependymomal tumors<ref name=radio>.Ependymomas Dr Bruno Di Muzio and Dr Frank Gaillard Gold Supporter since June 24, 2015">. Radiopaedia.org 2015.http://radiopaedia.org/articles/ependymoma</ref>

==Epidemiology and Demographics==
===Incidence===
*The incidence of ependymoma is approximately 0.05 to 0.08 per 100,000 individuals in the United States.<ref name="cancergov">National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/publications/pdq</ref>
===Age===
* The posterior fossa tumors tend to present more commonly among the paediatric age group (mean age at diagnosis is 6 years of age)
* Subependymoma usually affects people older than 40 years of age.

===Gender===
*Men and women are affected equally by ependymomal tumors<ref name=radio>.Ependymomas Dr Bruno Di Muzio and Dr Frank Gaillard Gold Supporter since June 24, 2015">. Radiopaedia.org 2015.http://radiopaedia.org/articles/ependymoma</ref>
* Subependymoma more often affects men than women.
==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma epidemiology and demographics

2015-10-16T12:47:05Z

Ahmad Al Maradni: /* Overview */

__NOTOC__
{{Ependymoma}}

{{CMG}} {{AE}} {{AAM}}

==Overview==
The incidence of ependymoma is approximately 0.05 to 0.08 per 100,000 individuals in the United States.<ref name="cancergov">National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/publications/pdq</ref> The posterior fossa tumours tend to present more commonly in the paediatric age group (mean age at diagnosis is 6 years of age). Male and Female are affected equally by ependymomal tumors<ref name=radio>.Ependymomas Dr Bruno Di Muzio and Dr Frank Gaillard Gold Supporter since June 24, 2015">. Radiopaedia.org 2015.http://radiopaedia.org/articles/ependymoma</ref>

==Epidemiology and Demographics==
===Incidence===
*The incidence of ependymoma is approximately 0.05 to 0.08 per 100,000 individuals in the United States.<ref name="cancergov">National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/publications/pdq</ref>
===Age===
* The posterior fossa tumors tend to present more commonly among the paediatric age group (mean age at diagnosis is 6 years of age)
* Subependymoma usually affects people over than 40 years of age.

===Gender===
*Men and women are affected equally by ependymomal tumors<ref name=radio>.Ependymomas Dr Bruno Di Muzio and Dr Frank Gaillard Gold Supporter since June 24, 2015">. Radiopaedia.org 2015.http://radiopaedia.org/articles/ependymoma</ref>
* Subependymoma more often affects men than women.
==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma pathophysiology

2015-10-16T12:45:43Z

Ahmad Al Maradni: /* Genetics */

__NOTOC__
{{Ependymoma}}
{{CMG}} {{AE}} {{AAM}}

==Overview==
On [[gross pathology]], a well-encapsulated [[tumor]] which arises from the floor of the [[fourth ventricle]], situated in the lower back portion of the [[brain]] is a characteristic finding of ependymoma. On [[microscopic]] histopathological analysis, perivascular pseudorosettes are characteristic findings of ependymoma. Development of ependymoma is the result of multiple genetic mutations (''ERBB2'', ''ERBB4'', ''[[MMP2]]'', ''MMP14'', ''[[NOTCH1]]'', and ''[[MEN1]]'').<ref name=Epe>Kumar, et al. (2005). The Central Nervous System. Pathologic Basis of Disease. 7th Edition. Philadelphia: Elsevier Saunders.</ref><ref name=Wikipedia> ependymoma https://en.wikipedia.org/wiki/Pediatric_ependymoma#Cell_of_origin URL Accessed on 10/08/2015</ref>
==Genetics==

*[[Posterior fossa]] ependymoma can be divided into the following two groups based on distinctive patterns of [[gene expression]].<ref name="pmid22322993">{{cite journal| author=Wani K, Armstrong TS, Vera-Bolanos E, Raghunathan A, Ellison D, Gilbertson R et al.| title=A prognostic gene expression signature in infratentorial ependymoma. | journal=Acta Neuropathol | year= 2012 | volume= 123 | issue= 5 | pages= 727-38 | pmid=22322993 | doi=10.1007/s00401-012-0941-4 | pmc=PMC4013829 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22322993 }} </ref><ref name="pmid21840481">{{cite journal| author=Witt H, Mack SC, Ryzhova M, Bender S, Sill M, Isserlin R et al.| title=Delineation of two clinically and molecularly distinct subgroups of posterior fossa ependymoma. | journal=Cancer Cell | year= 2011 | volume= 20 | issue= 2 | pages= 143-57 | pmid=21840481 | doi=10.1016/j.ccr.2011.07.007 | pmc=PMC4154494 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21840481 }} </ref><ref name=Cancergove> Eoendymoma. http://www.cancer.gov/types/brain/hp/child-ependymoma-treatment-pdq#section/_35 URL Accessed on 10 6 2015.</ref>

*One expression-defined group occurs primarily in young children and is characterized by a largely balanced genomic profile with an increased occurrence of ''chromosome 1q'' and proteins such as [[tenascin C]] and [[epidermal growth factor]] receptor.<ref name="pmid10967185">{{cite journal| author=Korshunov A, Golanov A, Timirgaz V| title=Immunohistochemical markers for intracranial ependymoma recurrence. An analysis of 88 cases. | journal=J Neurol Sci | year= 2000 | volume= 177 | issue= 1 | pages= 72-82 | pmid=10967185 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10967185 }} </ref><ref name="pmid16609018">{{cite journal| author=Mendrzyk F, Korshunov A, Benner A, Toedt G, Pfister S, Radlwimmer B et al.| title=Identification of gains on 1q and epidermal growth factor receptor overexpression as independent prognostic markers in intracranial ependymoma. | journal=Clin Cancer Res | year= 2006 | volume= 12 | issue= 7 Pt 1 | pages= 2070-9 | pmid=16609018 | doi=10.1158/1078-0432.CCR-05-2363 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16609018 }} </ref>
*The second expression-defined group occurs primarily in older children and adults and is characterized by a numerous [[cytogenetic]] abnormalities involving the whole [[chromosome]] or chromosomal arms.<ref name="pmid22322993">{{cite journal| author=Wani K, Armstrong TS, Vera-Bolanos E, Raghunathan A, Ellison D, Gilbertson R et al.| title=A prognostic gene expression signature in infratentorial ependymoma. | journal=Acta Neuropathol | year= 2012 | volume= 123 | issue= 5 | pages= 727-38 | pmid=22322993 | doi=10.1007/s00401-012-0941-4 | pmc=PMC4013829 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22322993 }} </ref>
*Genes involved in ependymoma formation and progression are:<ref name=Wikipedia> ependymoma https://en.wikipedia.org/wiki/Pediatric_ependymoma#Cell_of_origin URL Accessed on 10/08/2015</ref>
:*''ERBB2''
:*''ERBB4''
:*Human telomerase [[reverse transcriptase]] ''[[TERT]]''
:*''KIT'' receptor [[tyrosine kinase]] and phospho-''KIT'' receptor expression is associated with tumor progression
:*''[[MMP2]]'' and ''MMP14'' mutations appear to also play a role in tumor growth and progression in intracranial cases.
:*''[[NOTCH1]]'' mutations have been found in approximately 8% of pediatric ependymomas
:* ''[[MEN1]]'' mutations are occasionally found in pediatric ependymomas.
:*''TPR'' and ''CHIBBY'' mutations have been identified in pediatric ependymomas.
:* ''[[S100A6]]'' and ''[[S100A4]]'' on chromosome 1q have also been found to correspond to supratentorial tumor development and tumors occurring before the age of 3 years.

==Associated Conditions==
*The subependymal giant-cell astrocytoma, also called giant-cell glioma, is typically associated with [[tuberous sclerosis]] but can occur independently.

==Pathology==
*Ependymomas represent a relatively broad group of glial tumors which share common origin from differentiated ependymal cells lining the ventricles of the brain or the central canal of the spinal cord. They account for 5% of all neuroepithelial neoplasms.
*Ependymomas can occur anywhere, but certain location are typical. Common locations include:
:*Floor of the [[fourth ventricle]] (common location in children)
:*[[Spinal cord]] ependymoma
:*Myxopapillary ependymoma (conus medullaris)
:*[[Supratentorial]] ependymoma
*The subependymomas, variant of the ependymoma, arise in the fourth ventricle but may occur in the [[septum pellucidum]] and the cervical spinal cord.
==Gross Pathology==
*Ependymomas are well-encapsulated tumors which usually arise from the floor of the [[fourth ventricle]].
<Gallery>
Epyndemomas gross.jpg| Fourth ventricle ependymomas frequently extend out of the ventricle into the [[subarachnoid space]].<ref name=libre>EPENDYMOMA. http://librepathology.org/wiki/index.php/File:AFIP405713G-EPENDYMOMA.jpg 2015. URL Accessed on 10 6, 2015</ref>
</gallery>
==Microscopic Pathology==
*Ependymomas are composed of cells with regular, round to oval [[nuclei]]. There is a variably dense fibrillary background.
*Tumor cells may form gland-like round or elongated structures that resemble the embryologic [[ependyma|ependymal canal]], with long, delicate processes extending into the lumen; more frequently present are perivascular pseudorosettes in which tumor cells are arranged around vessels with an intervening zone consisting of thin ependymal processes directed toward the wall of the vessel.<ref name=Epe>Kumar, et al. (2005). The Central Nervous System. Pathologic Basis of Disease. 7th Edition. Philadelphia: Elsevier Saunders.</ref>
*Ependymal rosettes are rare but pathognomonic feature.

<Gallery>
Image:532px-Ependymoma low intermed mag.jpg|Micrograph of an ependymoma. H&E stain show pseudoressettes pattern of ependymal cells.<ref name=Wikipedia> Ependymoma. https://en.wikipedia.org/wiki/Ependymoma#/media/File:Ependymoma_low_intermed_mag.jpg. URL Accessed on 10 6, 2015</ref>
Image:True ependymal rossettes.jpg|True ependymal rosette consisting of tumor cells arranged around well-defined lumens forming gland-like structures.<ref name=radiopaedia> Image courtesy of Dr Dharam Ramnani[http://www.radiopaedia.org Radiopaedia] (original file
[http://radiopaedia.org/cases/ependymoma-true-ependymal-rosettes ‘’here’’]).[http://radiopaedia.org/licence] Creative
Commons BY-SA-NC</ref>
Image:Ependymoma-true-ependymal-rosettes123.jpg|Higher magnification of one of the true ependymal rosettes showing a collar of cells around a central lumen forming a gland-like structure.<ref name=radiopaedia> Image courtesy of Dr Dharam Ramnani[http://www.radiopaedia.org Radiopaedia] (original file[http://radiopaedia.org/cases/ependymoma-true-ependymal-rosettes ''here'']). [http://radiopaedia.org/licence] CreativeCommons BY-SANC</ref>
</gallery>

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma pathophysiology

2015-10-15T20:13:55Z

Ahmad Al Maradni: /* Associated Conditions */

__NOTOC__
{{Ependymoma}}
{{CMG}} {{AE}} {{AAM}}

==Overview==
On [[gross pathology]], a well-encapsulated [[tumor]] which arises from the floor of the [[fourth ventricle]], situated in the lower back portion of the [[brain]] is a characteristic finding of ependymoma. On [[microscopic]] histopathological analysis, perivascular pseudorosettes are characteristic findings of ependymoma. Development of ependymoma is the result of multiple genetic mutations (''ERBB2'', ''ERBB4'', ''[[MMP2]]'', ''MMP14'', ''[[NOTCH1]]'', and ''[[MEN1]]'').<ref name=Epe>Kumar, et al. (2005). The Central Nervous System. Pathologic Basis of Disease. 7th Edition. Philadelphia: Elsevier Saunders.</ref><ref name=Wikipedia> ependymoma https://en.wikipedia.org/wiki/Pediatric_ependymoma#Cell_of_origin URL Accessed on 10/08/2015</ref>
==Genetics==

*[[Posterior fossa]] ependymoma can be divided into the following two groups based on distinctive patterns of [[gene expression]].<ref name="pmid22322993">{{cite journal| author=Wani K, Armstrong TS, Vera-Bolanos E, Raghunathan A, Ellison D, Gilbertson R et al.| title=A prognostic gene expression signature in infratentorial ependymoma. | journal=Acta Neuropathol | year= 2012 | volume= 123 | issue= 5 | pages= 727-38 | pmid=22322993 | doi=10.1007/s00401-012-0941-4 | pmc=PMC4013829 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22322993 }} </ref><ref name="pmid21840481">{{cite journal| author=Witt H, Mack SC, Ryzhova M, Bender S, Sill M, Isserlin R et al.| title=Delineation of two clinically and molecularly distinct subgroups of posterior fossa ependymoma. | journal=Cancer Cell | year= 2011 | volume= 20 | issue= 2 | pages= 143-57 | pmid=21840481 | doi=10.1016/j.ccr.2011.07.007 | pmc=PMC4154494 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21840481 }} </ref><ref name=Cancergove> Eoendymoma. http://www.cancer.gov/types/brain/hp/child-ependymoma-treatment-pdq#section/_35 URL Accessed on 10 6 2015.</ref>

*One expression-defined group occurs primarily in young children and is characterized by a largely balanced genomic profile with an increased occurrence of ''chromosome 1q'' and proteins such as [[tenascin C]] and [[epidermal growth factor]] receptor.<ref name="pmid10967185">{{cite journal| author=Korshunov A, Golanov A, Timirgaz V| title=Immunohistochemical markers for intracranial ependymoma recurrence. An analysis of 88 cases. | journal=J Neurol Sci | year= 2000 | volume= 177 | issue= 1 | pages= 72-82 | pmid=10967185 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10967185 }} </ref><ref name="pmid16609018">{{cite journal| author=Mendrzyk F, Korshunov A, Benner A, Toedt G, Pfister S, Radlwimmer B et al.| title=Identification of gains on 1q and epidermal growth factor receptor overexpression as independent prognostic markers in intracranial ependymoma. | journal=Clin Cancer Res | year= 2006 | volume= 12 | issue= 7 Pt 1 | pages= 2070-9 | pmid=16609018 | doi=10.1158/1078-0432.CCR-05-2363 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16609018 }} </ref>
*The second expression-defined group occurs primarily in older children and adults and is characterized by a numerous [[cytogenetic]] abnormalities involving the whole [[chromosome]] or chromosomal arms.<ref name="pmid22322993">{{cite journal| author=Wani K, Armstrong TS, Vera-Bolanos E, Raghunathan A, Ellison D, Gilbertson R et al.| title=A prognostic gene expression signature in infratentorial ependymoma. | journal=Acta Neuropathol | year= 2012 | volume= 123 | issue= 5 | pages= 727-38 | pmid=22322993 | doi=10.1007/s00401-012-0941-4 | pmc=PMC4013829 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22322993 }} </ref>
*Genes involved in ependymoma formation and progression are:<ref name=Wikipedia> ependymoma https://en.wikipedia.org/wiki/Pediatric_ependymoma#Cell_of_origin URL Accessed on 10/08/2015</ref>
:*''ERBB2''
:*''ERBB4''
:*Human telomerase [[reverse transcriptase]] ''[[TERT]]''
:*''KIT'' receptor [[tyrosine kinase]] and phospho-''KIT'' receptor expression is associated with tumor progression
:*''[[MMP2]]'' and ''MMP14'' appear to also play a role in tumor growth and progression in intracranial cases.
:*''[[NOTCH1]]'' mutations have been found in approximately 8% of pediatric ependymomas
:* ''[[MEN1]]'' mutations are occasionally found in pediatric ependymomas.
:*''TPR'' and ''CHIBBY'', have been identified in pediatric ependymomas.
:* ''[[S100A6]]'' and ''[[S100A4]]'' on chromosome 1q have also been found to correspond to supratentorial tumor development and tumors occurring before the age of 3 years.
==Associated Conditions==
*The subependymal giant-cell astrocytoma, also called giant-cell glioma, is typically associated with [[tuberous sclerosis]] but can occur independently.

==Pathology==
*Ependymomas represent a relatively broad group of glial tumors which share common origin from differentiated ependymal cells lining the ventricles of the brain or the central canal of the spinal cord. They account for 5% of all neuroepithelial neoplasms.
*Ependymomas can occur anywhere, but certain location are typical. Common locations include:
:*Floor of the [[fourth ventricle]] (common location in children)
:*[[Spinal cord]] ependymoma
:*Myxopapillary ependymoma (conus medullaris)
:*[[Supratentorial]] ependymoma
*The subependymomas, variant of the ependymoma, arise in the fourth ventricle but may occur in the [[septum pellucidum]] and the cervical spinal cord.
==Gross Pathology==
*Ependymomas are well-encapsulated tumors which usually arise from the floor of the [[fourth ventricle]].
<Gallery>
Epyndemomas gross.jpg| Fourth ventricle ependymomas frequently extend out of the ventricle into the [[subarachnoid space]].<ref name=libre>EPENDYMOMA. http://librepathology.org/wiki/index.php/File:AFIP405713G-EPENDYMOMA.jpg 2015. URL Accessed on 10 6, 2015</ref>
</gallery>
==Microscopic Pathology==
*Ependymomas are composed of cells with regular, round to oval [[nuclei]]. There is a variably dense fibrillary background.
*Tumor cells may form gland-like round or elongated structures that resemble the embryologic [[ependyma|ependymal canal]], with long, delicate processes extending into the lumen; more frequently present are perivascular pseudorosettes in which tumor cells are arranged around vessels with an intervening zone consisting of thin ependymal processes directed toward the wall of the vessel.<ref name=Epe>Kumar, et al. (2005). The Central Nervous System. Pathologic Basis of Disease. 7th Edition. Philadelphia: Elsevier Saunders.</ref>
*Ependymal rosettes are rare but pathognomonic feature.

<Gallery>
Image:532px-Ependymoma low intermed mag.jpg|Micrograph of an ependymoma. H&E stain show pseudoressettes pattern of ependymal cells.<ref name=Wikipedia> Ependymoma. https://en.wikipedia.org/wiki/Ependymoma#/media/File:Ependymoma_low_intermed_mag.jpg. URL Accessed on 10 6, 2015</ref>
Image:True ependymal rossettes.jpg|True ependymal rosette consisting of tumor cells arranged around well-defined lumens forming gland-like structures.<ref name=radiopaedia> Image courtesy of Dr Dharam Ramnani[http://www.radiopaedia.org Radiopaedia] (original file
[http://radiopaedia.org/cases/ependymoma-true-ependymal-rosettes ‘’here’’]).[http://radiopaedia.org/licence] Creative
Commons BY-SA-NC</ref>
Image:Ependymoma-true-ependymal-rosettes123.jpg|Higher magnification of one of the true ependymal rosettes showing a collar of cells around a central lumen forming a gland-like structure.<ref name=radiopaedia> Image courtesy of Dr Dharam Ramnani[http://www.radiopaedia.org Radiopaedia] (original file[http://radiopaedia.org/cases/ependymoma-true-ependymal-rosettes ''here'']). [http://radiopaedia.org/licence] CreativeCommons BY-SANC</ref>
</gallery>

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma pathophysiology

2015-10-15T20:13:30Z

Ahmad Al Maradni:

__NOTOC__
{{Ependymoma}}
{{CMG}} {{AE}} {{AAM}}

==Overview==
On [[gross pathology]], a well-encapsulated [[tumor]] which arises from the floor of the [[fourth ventricle]], situated in the lower back portion of the [[brain]] is a characteristic finding of ependymoma. On [[microscopic]] histopathological analysis, perivascular pseudorosettes are characteristic findings of ependymoma. Development of ependymoma is the result of multiple genetic mutations (''ERBB2'', ''ERBB4'', ''[[MMP2]]'', ''MMP14'', ''[[NOTCH1]]'', and ''[[MEN1]]'').<ref name=Epe>Kumar, et al. (2005). The Central Nervous System. Pathologic Basis of Disease. 7th Edition. Philadelphia: Elsevier Saunders.</ref><ref name=Wikipedia> ependymoma https://en.wikipedia.org/wiki/Pediatric_ependymoma#Cell_of_origin URL Accessed on 10/08/2015</ref>
==Genetics==

*[[Posterior fossa]] ependymoma can be divided into the following two groups based on distinctive patterns of [[gene expression]].<ref name="pmid22322993">{{cite journal| author=Wani K, Armstrong TS, Vera-Bolanos E, Raghunathan A, Ellison D, Gilbertson R et al.| title=A prognostic gene expression signature in infratentorial ependymoma. | journal=Acta Neuropathol | year= 2012 | volume= 123 | issue= 5 | pages= 727-38 | pmid=22322993 | doi=10.1007/s00401-012-0941-4 | pmc=PMC4013829 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22322993 }} </ref><ref name="pmid21840481">{{cite journal| author=Witt H, Mack SC, Ryzhova M, Bender S, Sill M, Isserlin R et al.| title=Delineation of two clinically and molecularly distinct subgroups of posterior fossa ependymoma. | journal=Cancer Cell | year= 2011 | volume= 20 | issue= 2 | pages= 143-57 | pmid=21840481 | doi=10.1016/j.ccr.2011.07.007 | pmc=PMC4154494 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21840481 }} </ref><ref name=Cancergove> Eoendymoma. http://www.cancer.gov/types/brain/hp/child-ependymoma-treatment-pdq#section/_35 URL Accessed on 10 6 2015.</ref>

*One expression-defined group occurs primarily in young children and is characterized by a largely balanced genomic profile with an increased occurrence of ''chromosome 1q'' and proteins such as [[tenascin C]] and [[epidermal growth factor]] receptor.<ref name="pmid10967185">{{cite journal| author=Korshunov A, Golanov A, Timirgaz V| title=Immunohistochemical markers for intracranial ependymoma recurrence. An analysis of 88 cases. | journal=J Neurol Sci | year= 2000 | volume= 177 | issue= 1 | pages= 72-82 | pmid=10967185 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10967185 }} </ref><ref name="pmid16609018">{{cite journal| author=Mendrzyk F, Korshunov A, Benner A, Toedt G, Pfister S, Radlwimmer B et al.| title=Identification of gains on 1q and epidermal growth factor receptor overexpression as independent prognostic markers in intracranial ependymoma. | journal=Clin Cancer Res | year= 2006 | volume= 12 | issue= 7 Pt 1 | pages= 2070-9 | pmid=16609018 | doi=10.1158/1078-0432.CCR-05-2363 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16609018 }} </ref>
*The second expression-defined group occurs primarily in older children and adults and is characterized by a numerous [[cytogenetic]] abnormalities involving the whole [[chromosome]] or chromosomal arms.<ref name="pmid22322993">{{cite journal| author=Wani K, Armstrong TS, Vera-Bolanos E, Raghunathan A, Ellison D, Gilbertson R et al.| title=A prognostic gene expression signature in infratentorial ependymoma. | journal=Acta Neuropathol | year= 2012 | volume= 123 | issue= 5 | pages= 727-38 | pmid=22322993 | doi=10.1007/s00401-012-0941-4 | pmc=PMC4013829 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22322993 }} </ref>
*Genes involved in ependymoma formation and progression are:<ref name=Wikipedia> ependymoma https://en.wikipedia.org/wiki/Pediatric_ependymoma#Cell_of_origin URL Accessed on 10/08/2015</ref>
:*''ERBB2''
:*''ERBB4''
:*Human telomerase [[reverse transcriptase]] ''[[TERT]]''
:*''KIT'' receptor [[tyrosine kinase]] and phospho-''KIT'' receptor expression is associated with tumor progression
:*''[[MMP2]]'' and ''MMP14'' appear to also play a role in tumor growth and progression in intracranial cases.
:*''[[NOTCH1]]'' mutations have been found in approximately 8% of pediatric ependymomas
:* ''[[MEN1]]'' mutations are occasionally found in pediatric ependymomas.
:*''TPR'' and ''CHIBBY'', have been identified in pediatric ependymomas.
:* ''[[S100A6]]'' and ''[[S100A4]]'' on chromosome 1q have also been found to correspond to supratentorial tumor development and tumors occurring before the age of 3 years.
==Associated Conditions==
The subependymal giant-cell astrocytoma, also called giant-cell glioma, is typically associated with [[tuberous sclerosis]] but can occur independently.

==Pathology==
*Ependymomas represent a relatively broad group of glial tumors which share common origin from differentiated ependymal cells lining the ventricles of the brain or the central canal of the spinal cord. They account for 5% of all neuroepithelial neoplasms.
*Ependymomas can occur anywhere, but certain location are typical. Common locations include:
:*Floor of the [[fourth ventricle]] (common location in children)
:*[[Spinal cord]] ependymoma
:*Myxopapillary ependymoma (conus medullaris)
:*[[Supratentorial]] ependymoma
*The subependymomas, variant of the ependymoma, arise in the fourth ventricle but may occur in the [[septum pellucidum]] and the cervical spinal cord.
==Gross Pathology==
*Ependymomas are well-encapsulated tumors which usually arise from the floor of the [[fourth ventricle]].
<Gallery>
Epyndemomas gross.jpg| Fourth ventricle ependymomas frequently extend out of the ventricle into the [[subarachnoid space]].<ref name=libre>EPENDYMOMA. http://librepathology.org/wiki/index.php/File:AFIP405713G-EPENDYMOMA.jpg 2015. URL Accessed on 10 6, 2015</ref>
</gallery>
==Microscopic Pathology==
*Ependymomas are composed of cells with regular, round to oval [[nuclei]]. There is a variably dense fibrillary background.
*Tumor cells may form gland-like round or elongated structures that resemble the embryologic [[ependyma|ependymal canal]], with long, delicate processes extending into the lumen; more frequently present are perivascular pseudorosettes in which tumor cells are arranged around vessels with an intervening zone consisting of thin ependymal processes directed toward the wall of the vessel.<ref name=Epe>Kumar, et al. (2005). The Central Nervous System. Pathologic Basis of Disease. 7th Edition. Philadelphia: Elsevier Saunders.</ref>
*Ependymal rosettes are rare but pathognomonic feature.

<Gallery>
Image:532px-Ependymoma low intermed mag.jpg|Micrograph of an ependymoma. H&E stain show pseudoressettes pattern of ependymal cells.<ref name=Wikipedia> Ependymoma. https://en.wikipedia.org/wiki/Ependymoma#/media/File:Ependymoma_low_intermed_mag.jpg. URL Accessed on 10 6, 2015</ref>
Image:True ependymal rossettes.jpg|True ependymal rosette consisting of tumor cells arranged around well-defined lumens forming gland-like structures.<ref name=radiopaedia> Image courtesy of Dr Dharam Ramnani[http://www.radiopaedia.org Radiopaedia] (original file
[http://radiopaedia.org/cases/ependymoma-true-ependymal-rosettes ‘’here’’]).[http://radiopaedia.org/licence] Creative
Commons BY-SA-NC</ref>
Image:Ependymoma-true-ependymal-rosettes123.jpg|Higher magnification of one of the true ependymal rosettes showing a collar of cells around a central lumen forming a gland-like structure.<ref name=radiopaedia> Image courtesy of Dr Dharam Ramnani[http://www.radiopaedia.org Radiopaedia] (original file[http://radiopaedia.org/cases/ependymoma-true-ependymal-rosettes ''here'']). [http://radiopaedia.org/licence] CreativeCommons BY-SANC</ref>
</gallery>

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma pathophysiology

2015-10-15T20:08:08Z

Ahmad Al Maradni: /* Pathology */

__NOTOC__
{{Ependymoma}}
{{CMG}} {{AE}} {{AAM}}

==Overview==
On [[gross pathology]], a well-encapsulated [[tumor]] which arises from the floor of the [[fourth ventricle]], situated in the lower back portion of the [[brain]] is a characteristic finding of ependymoma. On [[microscopic]] histopathological analysis, perivascular pseudorosettes are characteristic findings of ependymoma. Development of ependymoma is the result of multiple genetic mutations (''ERBB2'', ''ERBB4'', ''[[MMP2]]'', ''MMP14'', ''[[NOTCH1]]'', and ''[[MEN1]]'').<ref name=Epe>Kumar, et al. (2005). The Central Nervous System. Pathologic Basis of Disease. 7th Edition. Philadelphia: Elsevier Saunders.</ref><ref name=Wikipedia> ependymoma https://en.wikipedia.org/wiki/Pediatric_ependymoma#Cell_of_origin URL Accessed on 10/08/2015</ref>

==Pathology==

*Ependymomas represent a relatively broad group of glial tumors which share common origin from differentiated ependymal cells lining the ventricles of the brain or the central canal of the spinal cord. They account for 5% of all neuroepithelial neoplasms.
*Ependymomas can occur anywhere, but certain location are typical. Common locations include:
:*Floor of the [[fourth ventricle]] (common location in children)
:*[[Spinal cord]] ependymoma
:*Myxopapillary ependymoma (conus medullaris)
:*[[Supratentorial]] ependymoma
*The subependymomas, variant of the ependymoma, arise in the fourth ventricle but may occur in the [[septum pellucidum]] and the cervical spinal cord.
===Gross Pathology===
*Ependymomas are well-encapsulated tumors which usually arise from the floor of the [[fourth ventricle]].
<Gallery>
Epyndemomas gross.jpg| Fourth ventricle ependymomas frequently extend out of the ventricle into the [[subarachnoid space]].<ref name=libre>EPENDYMOMA. http://librepathology.org/wiki/index.php/File:AFIP405713G-EPENDYMOMA.jpg 2015. URL Accessed on 10 6, 2015</ref>
</gallery>

===Microscopic Pathology===
*Ependymomas are composed of cells with regular, round to oval [[nuclei]]. There is a variably dense fibrillary background.
*Tumor cells may form gland-like round or elongated structures that resemble the embryologic [[ependyma|ependymal canal]], with long, delicate processes extending into the lumen; more frequently present are perivascular pseudorosettes in which tumor cells are arranged around vessels with an intervening zone consisting of thin ependymal processes directed toward the wall of the vessel.<ref name=Epe>Kumar, et al. (2005). The Central Nervous System. Pathologic Basis of Disease. 7th Edition. Philadelphia: Elsevier Saunders.</ref>
*Ependymal rosettes are rare but pathognomonic feature.

<Gallery>
Image:532px-Ependymoma low intermed mag.jpg|Micrograph of an ependymoma. H&E stain show pseudoressettes pattern of ependymal cells.<ref name=Wikipedia> Ependymoma. https://en.wikipedia.org/wiki/Ependymoma#/media/File:Ependymoma_low_intermed_mag.jpg. URL Accessed on 10 6, 2015</ref>
Image:True ependymal rossettes.jpg|True ependymal rosette consisting of tumor cells arranged around well-defined lumens forming gland-like structures.<ref name=radiopaedia> Image courtesy of Dr Dharam Ramnani[http://www.radiopaedia.org Radiopaedia] (original file
[http://radiopaedia.org/cases/ependymoma-true-ependymal-rosettes ‘’here’’]).[http://radiopaedia.org/licence] Creative
Commons BY-SA-NC</ref>
Image:Ependymoma-true-ependymal-rosettes123.jpg|Higher magnification of one of the true ependymal rosettes showing a collar of cells around a central lumen forming a gland-like structure.<ref name=radiopaedia> Image courtesy of Dr Dharam Ramnani[http://www.radiopaedia.org Radiopaedia] (original file[http://radiopaedia.org/cases/ependymoma-true-ependymal-rosettes ''here'']). [http://radiopaedia.org/licence] CreativeCommons BY-SANC</ref>
</gallery>

==Associated Conditions==
The subependymal giant-cell astrocytoma, also called giant-cell glioma, is typically associated with [[tuberous sclerosis]] but can occur independently.

==Genetics==

*[[Posterior fossa]] ependymoma can be divided into the following two groups based on distinctive patterns of [[gene expression]].<ref name="pmid22322993">{{cite journal| author=Wani K, Armstrong TS, Vera-Bolanos E, Raghunathan A, Ellison D, Gilbertson R et al.| title=A prognostic gene expression signature in infratentorial ependymoma. | journal=Acta Neuropathol | year= 2012 | volume= 123 | issue= 5 | pages= 727-38 | pmid=22322993 | doi=10.1007/s00401-012-0941-4 | pmc=PMC4013829 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22322993 }} </ref><ref name="pmid21840481">{{cite journal| author=Witt H, Mack SC, Ryzhova M, Bender S, Sill M, Isserlin R et al.| title=Delineation of two clinically and molecularly distinct subgroups of posterior fossa ependymoma. | journal=Cancer Cell | year= 2011 | volume= 20 | issue= 2 | pages= 143-57 | pmid=21840481 | doi=10.1016/j.ccr.2011.07.007 | pmc=PMC4154494 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21840481 }} </ref><ref name=Cancergove> Eoendymoma. http://www.cancer.gov/types/brain/hp/child-ependymoma-treatment-pdq#section/_35 URL Accessed on 10 6 2015.</ref>

*One expression-defined group occurs primarily in young children and is characterized by a largely balanced genomic profile with an increased occurrence of ''chromosome 1q'' and proteins such as [[tenascin C]] and [[epidermal growth factor]] receptor.<ref name="pmid10967185">{{cite journal| author=Korshunov A, Golanov A, Timirgaz V| title=Immunohistochemical markers for intracranial ependymoma recurrence. An analysis of 88 cases. | journal=J Neurol Sci | year= 2000 | volume= 177 | issue= 1 | pages= 72-82 | pmid=10967185 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10967185 }} </ref><ref name="pmid16609018">{{cite journal| author=Mendrzyk F, Korshunov A, Benner A, Toedt G, Pfister S, Radlwimmer B et al.| title=Identification of gains on 1q and epidermal growth factor receptor overexpression as independent prognostic markers in intracranial ependymoma. | journal=Clin Cancer Res | year= 2006 | volume= 12 | issue= 7 Pt 1 | pages= 2070-9 | pmid=16609018 | doi=10.1158/1078-0432.CCR-05-2363 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16609018 }} </ref>
*The second expression-defined group occurs primarily in older children and adults and is characterized by a numerous [[cytogenetic]] abnormalities involving the whole [[chromosome]] or chromosomal arms.<ref name="pmid22322993">{{cite journal| author=Wani K, Armstrong TS, Vera-Bolanos E, Raghunathan A, Ellison D, Gilbertson R et al.| title=A prognostic gene expression signature in infratentorial ependymoma. | journal=Acta Neuropathol | year= 2012 | volume= 123 | issue= 5 | pages= 727-38 | pmid=22322993 | doi=10.1007/s00401-012-0941-4 | pmc=PMC4013829 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22322993 }} </ref>
*Genes involved in ependymoma formation and progression are:<ref name=Wikipedia> ependymoma https://en.wikipedia.org/wiki/Pediatric_ependymoma#Cell_of_origin URL Accessed on 10/08/2015</ref>
:*''ERBB2''
:*''ERBB4''
:*Human telomerase [[reverse transcriptase]] ''[[TERT]]''
:*''KIT'' receptor [[tyrosine kinase]] and phospho-''KIT'' receptor expression is associated with tumor progression
:*''[[MMP2]]'' and ''MMP14'' appear to also play a role in tumor growth and progression in intracranial cases.
:*''[[NOTCH1]]'' mutations have been found in approximately 8% of pediatric ependymomas
:* ''[[MEN1]]'' mutations are occasionally found in pediatric ependymomas.
:*''TPR'' and ''CHIBBY'', have been identified in pediatric ependymomas.
:* ''[[S100A6]]'' and ''[[S100A4]]'' on chromosome 1q have also been found to correspond to supratentorial tumor development and tumors occurring before the age of 3 years.

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Ependymoma pathophysiology

2015-10-15T20:07:40Z

Ahmad Al Maradni: /* Pathology */

__NOTOC__
{{Ependymoma}}
{{CMG}} {{AE}} {{AAM}}

==Overview==
On [[gross pathology]], a well-encapsulated [[tumor]] which arises from the floor of the [[fourth ventricle]], situated in the lower back portion of the [[brain]] is a characteristic finding of ependymoma. On [[microscopic]] histopathological analysis, perivascular pseudorosettes are characteristic findings of ependymoma. Development of ependymoma is the result of multiple genetic mutations (''ERBB2'', ''ERBB4'', ''[[MMP2]]'', ''MMP14'', ''[[NOTCH1]]'', and ''[[MEN1]]'').<ref name=Epe>Kumar, et al. (2005). The Central Nervous System. Pathologic Basis of Disease. 7th Edition. Philadelphia: Elsevier Saunders.</ref><ref name=Wikipedia> ependymoma https://en.wikipedia.org/wiki/Pediatric_ependymoma#Cell_of_origin URL Accessed on 10/08/2015</ref>

==Pathology==

*Ependymomas represent a relatively broad group of glial tumors which share common origin from differentiated ependymal cells lining the ventricles of the brain or the central canal of the spinal cord. They account for 5% of all neuroepithelial neoplasms, 10% of all paediatric brain tumors, and up to 33% of brain tumors occurring in those less than 3 years of age.
*Ependymomas can occur anywhere, but certain location are typical. Common locations include:
:*Floor of the [[fourth ventricle]] (common location in children)
:*[[Spinal cord]] ependymoma
:*Myxopapillary ependymoma (conus medullaris)
:*[[Supratentorial]] ependymoma
*The subependymomas, variant of the ependymoma, arise in the fourth ventricle but may occur in the [[septum pellucidum]] and the cervical spinal cord.
===Gross Pathology===
*Ependymomas are well-encapsulated tumors which usually arise from the floor of the [[fourth ventricle]].
<Gallery>
Epyndemomas gross.jpg| Fourth ventricle ependymomas frequently extend out of the ventricle into the [[subarachnoid space]].<ref name=libre>EPENDYMOMA. http://librepathology.org/wiki/index.php/File:AFIP405713G-EPENDYMOMA.jpg 2015. URL Accessed on 10 6, 2015</ref>
</gallery>

===Microscopic Pathology===
*Ependymomas are composed of cells with regular, round to oval [[nuclei]]. There is a variably dense fibrillary background.
*Tumor cells may form gland-like round or elongated structures that resemble the embryologic [[ependyma|ependymal canal]], with long, delicate processes extending into the lumen; more frequently present are perivascular pseudorosettes in which tumor cells are arranged around vessels with an intervening zone consisting of thin ependymal processes directed toward the wall of the vessel.<ref name=Epe>Kumar, et al. (2005). The Central Nervous System. Pathologic Basis of Disease. 7th Edition. Philadelphia: Elsevier Saunders.</ref>
*Ependymal rosettes are rare but pathognomonic feature.

<Gallery>
Image:532px-Ependymoma low intermed mag.jpg|Micrograph of an ependymoma. H&E stain show pseudoressettes pattern of ependymal cells.<ref name=Wikipedia> Ependymoma. https://en.wikipedia.org/wiki/Ependymoma#/media/File:Ependymoma_low_intermed_mag.jpg. URL Accessed on 10 6, 2015</ref>
Image:True ependymal rossettes.jpg|True ependymal rosette consisting of tumor cells arranged around well-defined lumens forming gland-like structures.<ref name=radiopaedia> Image courtesy of Dr Dharam Ramnani[http://www.radiopaedia.org Radiopaedia] (original file
[http://radiopaedia.org/cases/ependymoma-true-ependymal-rosettes ‘’here’’]).[http://radiopaedia.org/licence] Creative
Commons BY-SA-NC</ref>
Image:Ependymoma-true-ependymal-rosettes123.jpg|Higher magnification of one of the true ependymal rosettes showing a collar of cells around a central lumen forming a gland-like structure.<ref name=radiopaedia> Image courtesy of Dr Dharam Ramnani[http://www.radiopaedia.org Radiopaedia] (original file[http://radiopaedia.org/cases/ependymoma-true-ependymal-rosettes ''here'']). [http://radiopaedia.org/licence] CreativeCommons BY-SANC</ref>
</gallery>

==Associated Conditions==
The subependymal giant-cell astrocytoma, also called giant-cell glioma, is typically associated with [[tuberous sclerosis]] but can occur independently.

==Genetics==

*[[Posterior fossa]] ependymoma can be divided into the following two groups based on distinctive patterns of [[gene expression]].<ref name="pmid22322993">{{cite journal| author=Wani K, Armstrong TS, Vera-Bolanos E, Raghunathan A, Ellison D, Gilbertson R et al.| title=A prognostic gene expression signature in infratentorial ependymoma. | journal=Acta Neuropathol | year= 2012 | volume= 123 | issue= 5 | pages= 727-38 | pmid=22322993 | doi=10.1007/s00401-012-0941-4 | pmc=PMC4013829 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22322993 }} </ref><ref name="pmid21840481">{{cite journal| author=Witt H, Mack SC, Ryzhova M, Bender S, Sill M, Isserlin R et al.| title=Delineation of two clinically and molecularly distinct subgroups of posterior fossa ependymoma. | journal=Cancer Cell | year= 2011 | volume= 20 | issue= 2 | pages= 143-57 | pmid=21840481 | doi=10.1016/j.ccr.2011.07.007 | pmc=PMC4154494 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21840481 }} </ref><ref name=Cancergove> Eoendymoma. http://www.cancer.gov/types/brain/hp/child-ependymoma-treatment-pdq#section/_35 URL Accessed on 10 6 2015.</ref>

*One expression-defined group occurs primarily in young children and is characterized by a largely balanced genomic profile with an increased occurrence of ''chromosome 1q'' and proteins such as [[tenascin C]] and [[epidermal growth factor]] receptor.<ref name="pmid10967185">{{cite journal| author=Korshunov A, Golanov A, Timirgaz V| title=Immunohistochemical markers for intracranial ependymoma recurrence. An analysis of 88 cases. | journal=J Neurol Sci | year= 2000 | volume= 177 | issue= 1 | pages= 72-82 | pmid=10967185 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10967185 }} </ref><ref name="pmid16609018">{{cite journal| author=Mendrzyk F, Korshunov A, Benner A, Toedt G, Pfister S, Radlwimmer B et al.| title=Identification of gains on 1q and epidermal growth factor receptor overexpression as independent prognostic markers in intracranial ependymoma. | journal=Clin Cancer Res | year= 2006 | volume= 12 | issue= 7 Pt 1 | pages= 2070-9 | pmid=16609018 | doi=10.1158/1078-0432.CCR-05-2363 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16609018 }} </ref>
*The second expression-defined group occurs primarily in older children and adults and is characterized by a numerous [[cytogenetic]] abnormalities involving the whole [[chromosome]] or chromosomal arms.<ref name="pmid22322993">{{cite journal| author=Wani K, Armstrong TS, Vera-Bolanos E, Raghunathan A, Ellison D, Gilbertson R et al.| title=A prognostic gene expression signature in infratentorial ependymoma. | journal=Acta Neuropathol | year= 2012 | volume= 123 | issue= 5 | pages= 727-38 | pmid=22322993 | doi=10.1007/s00401-012-0941-4 | pmc=PMC4013829 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22322993 }} </ref>
*Genes involved in ependymoma formation and progression are:<ref name=Wikipedia> ependymoma https://en.wikipedia.org/wiki/Pediatric_ependymoma#Cell_of_origin URL Accessed on 10/08/2015</ref>
:*''ERBB2''
:*''ERBB4''
:*Human telomerase [[reverse transcriptase]] ''[[TERT]]''
:*''KIT'' receptor [[tyrosine kinase]] and phospho-''KIT'' receptor expression is associated with tumor progression
:*''[[MMP2]]'' and ''MMP14'' appear to also play a role in tumor growth and progression in intracranial cases.
:*''[[NOTCH1]]'' mutations have been found in approximately 8% of pediatric ependymomas
:* ''[[MEN1]]'' mutations are occasionally found in pediatric ependymomas.
:*''TPR'' and ''CHIBBY'', have been identified in pediatric ependymomas.
:* ''[[S100A6]]'' and ''[[S100A4]]'' on chromosome 1q have also been found to correspond to supratentorial tumor development and tumors occurring before the age of 3 years.

==References==
{{reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Neurology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}